Novel alpha-1-microglobulin derived proteins and their use

ABSTRACT

This invention relates to an alpha-1-microglobulin derived protein for medical use.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is the U.S. National Stage of International Application PCT/EP2017/056436, filed Mar. 17, 2017, and claims priority to Denmark Patent Application No. PA 2016 70158, filed Mar. 18, 2016.

SEQUENCE LISTING

The present application contains a Sequence Listing which has been submitted electronically in ASCII format and is hereby incorporated by reference in its entirety. Said ASCII copy, created on Jan. 15, 2019, is named 105454-0110_SL.txt and is 158,170 bytes in size.

FIELD OF THE INVENTION

The present invention relates to modified variants of human alpha-1-microglobulin protein with improved properties and the use of such variants in medical treatment and diagnostics. The inventors have surprisingly found that introduction of specific amino acid substitutions and/or addition of specific N-terminal extensions confer improved properties to alpha-1-microglobulin with regard to stability, solubility, and binding of heme.

BACKGROUND OF THE INVENTION

A1M (α₁-microglobulin) is a low molecular weight protein with an extracellular tissue-cleaning function (Ekström et al., 1977; Åkerström and Gram, 2014). It is present in all tissues and organs in fish, birds, rodents, mammals and other vertebrates. A1M is synthesized mainly in the liver but also at a lower rate in most other cells in the body. It is encoded by the α₁-microglobulin-bikunin precursor gene (AMBP) and translated in all cells and species as a continuous peptide precursor together with another protein, bikunin (Kaumeyer et al., 1986). However, the two proteins are separated by protease cleavage, processed and secreted into the blood as two different proteins with different functions (Lindqvist et al., 1992; Bratt et al., 1993). The reason for the ubiquitous cosynthesis of A1M and bikunin is still unknown. In the blood, about 50% of A1M is found in free, monomeric form, and the remaining 50% as high-molecular weight complexes covalently bound with immunoglobulin A, albumin and prothrombin (Berggård et al., 1997). A1M is a one-domain, 183-amino acid, glycosylated protein. The crystal structure of a large fragment of A1M expressed in E. coli was recently published (Meining and Skerra, 2012). Based on its structure, A1M belongs to a protein family, Lipocalins, with 50 or more members from animals, plants and bacteria (Flower, 1996; Åkerström et al., 2006). The lipocalins have a common three-dimensional structure which consists of eight antiparallel β-strands forming a barrel with one closed end (bottom) and an open end (top). The barrel functions as a pocket for hydrophobic ligands in most lipocalins. Four loops (loop 1-4), which make up the rim of the open end of the barrel, vary highly in length and composition between the various lipocalins. In A1M, a handful of amino acid side-groups located on these loops, or on the inside of the pocket, have been shown to be important for the identified functions of the protein. Thus, a free cysteine, C34, located on a short helix on loop 1, has a negative reduction potential and gives A1M reductase properties (Allhorn et al., 2005). Two tyrosine residues, Y22 and 132, were shown to be covalently modified by radical oxidation products in vitro (Åkerström et al., 2007). Four lysine residues, K69, 92, 118 and 130, regulate the reductase activity (Allhorn et al., 2005), influence the binding of free heme groups (Rutardottir et al., 2015), and are covalently modified on A1M purified from human urine and amniotic fluid with low molecular weight yellow-brown, heterogeneous substances (Berggård et al., 1999; Sala et al., 2004).

Employing the reductase activity, radical scavenging and heme-binding properties, A1M acts an antioxidant that protects cells and tissues from oxidative damage. A1M was shown to protect in vitro blood cell cultures, placenta tissue and skin against oxidative damage from hemoglobin, heme and reactive oxygen species (ROS) (Olsson et al., 2008; May et al., 2011; Olsson et al., PloS One 2011; Olsson et al., ARS 2012). A1M also showed in vivo protective effects in rats and rabbits against placenta and kidney tissue damage after hemoglobin infusion (Sverrison et al., 2014; Nääv et al., 2015). In a series of reports, hemoglobin and oxidative stress were shown to be involved in the pathogenesis of preeclampsia, a serious complication of pregnancy (Centlow et al., 2008; Hansson et al., 2013), and the levels of A1M-mRNA and protein in liver, placenta and plasma were elevated in pregnant women with preeclampsia (Olsson et al., 2010; Anderson et al., 2011). Therefore, it was suggested that A1M may be employed as a therapeutic agent to treat pregnant women with preeclampsia to ameliorate the oxidative damage and thus the clinical symptoms of the disease (Olsson et al., 2010).

A production process of recombinant human A1M was developed in E. coli and shown to possess the reductase, radical-binding and heme-binding properties (Kwasek et al., Allhorn et al., 2002; 2005; Åkerström et al., 2007). Indeed, this recombinant A1M variant showed in vivo therapeutic effects in a sheep model of preeclampsia (Wester-Rosenlöf et al., 2014). However, although functional, E. coli-expressed recombinant A1M lacks glycosylation, and has poor solubility and stability compared to human A1M purified from urine or plasma. The lack of stability and solubility of the protein limits its use as a drug for human use, mainly due to difficulties to obtain highly concentrated solutions and long-term storage conditions in buffers at physiological pH and salt conditions.

Accordingly, there is a need for developing a protein with structural similarities with human A1M, but with improved properties regarding stability and solubility. Moreover, the protein should be relatively easy to prepare in amounts suitable for therapeutic use.

DETAILED DESCRIPTION OF THE INVENTION

The present invention relates to novel alpha-1-microglobulin proteins with improved stability and solubility profiles.

Site-directed and additive mutagenesis was used to engineer A1M-species with retained, or possibly enhanced functional properties, but with improved protein stability and solubility that allow long-term storage at high concentrations in physiological buffers.

As it appears from the Examples herein, four lines of reasoning were followed when selecting the positions and identities of mutated amino acid side-groups:

1) Animal homologues from a variety of species with different expected environmental pressure in terms of oxidative stress, temperature, oxygen pressure were expressed (N=12);

2) Single amino acid substitutions that occur frequently among the 56 sequenced A1M-homologues at positions located in loops 1-4 or the interior surface of the hydrophobic pocket, were introduced into the human gene construct and expressed (N=3); and

3) Addition or removal of favourably located lysyl or tyrosyl residues, based on the hypothesis that these may infuence pKa of the C35 thiolyl (Allhorn et al., 2005) or serve as radical-trapping sites (Berggård et al., 1999; Sala et al., 2004; Åkerström et al. 2007) (N=5); 4).

In addition, the influence of N-terminal, charged and hydrophilic extensions were tested on some A1M-variants. The rationale behind the design of the tested N-terminal extensions was to add 1) a tag for purification (e.g. His-tag), 2) a linker to separate the tag from the core of the A1M protein, 3) several (1-5) charged amino acid side-groups conferring hydrophilic properties to the protein in order to gain maximal stability and solubility in water-solutions, 4) without compromising the physiological functions of A1M.

The project was divided into three major phases:

Phase I) Expression of the 27 A1M-variants described above followed by analysis of solubility, stability and function;

Phase II) Design, expression and analysis of a few A1M-variants with expected optimal properties based on the outcome of phase 1; and

Phase III) Design, expression and analysis of non-mutated wildtype (wt)-A1M and the most successful mutated A1M-variant equipped with or without N-terminal, charged and hydrophilic extensions.

As will be explained in more details herein, the present invention provides an A1M-derived protein having the amino acid sequence of formula I:

(SEQ ID NO: 10) X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²-X¹³-X¹⁴- GPVPTPPDN IQVQENF-X¹⁵-IS RIYGKWYNLA IGSTCPWLKK I- X¹⁶-DRMTVSTL VLGEGATEAE ISMTST-X¹⁷-WRK GVCEETSGAY EKTDTDGKFL YHKSKW-X¹⁸-ITM ESYVVHTNYD EY-AIFLTKKF SRHHGPTITA KLYGRAPQLR ETLLQDFRVV AQGVGIPEDS IFT- MADRGEC VPGEQEPEPI LIPR (formula I)

-   -   wherein at least one X is present and (in parentheses are         suggestions for further substitutions)     -   X¹ is absent or represents Met or N-formyl Met;     -   X² is absent or represents His;     -   X³ is absent or represents His;     -   X⁴ is absent or represents His;     -   X⁵ is absent or represents His;     -   X⁶ is absent or represents His;     -   X⁷ is absent or represents His;     -   X⁸ is absent or represents His;     -   X⁹ is absent or represents His;     -   X¹⁰ is absent or selected from Asp and Glu, Lys and Arg;     -   X¹¹ is absent or selected from Asp and Glu, Lys and Arg;     -   X¹² is absent or selected from Asp and Glu, Lys and Arg;     -   X¹³ is absent or selected from Asp and Glu, Lys and Arg;     -   X¹⁴ is absent or represents Lys Glu, Asp or Arg or Met or         N-formyl Met;     -   X¹⁵ represents Asp or Asn or Glu;     -   X¹⁶ represents Met or Lys or Arg;     -   X¹⁷ represents Arg or His or Lys;     -   X¹⁸ represents Asp or Asn or Glu;     -   or a pharmaceutically acceptable salt thereof,     -   with the proviso that when all X¹-X¹⁴ are absent, X¹⁵ represents         Asn, X¹⁶ represents Met, and X¹⁷ represents Arg, then X¹⁸ cannot         represent Asn.

The invention also provides a derivative of A1M, i.e. X¹-X¹⁴-A1M, wherein A1M may be any A1M obtained from the species mentioned in Table 2 (i.e. human, mouse, naked mole-rat, frog, chicken, rabbit, squirrel monkey, walrus, manatee, plaice and orangutan). The present inventors have found that inclusion of X¹-X¹⁴ imparts improved properties at least to human A1M, and accordingly, it is contemplated that this start sequence also can impart important improved properties to A1M from other species or to species-recombinant A1M.

The present invention also provides an A1M-derived protein having the amino acid sequence of formula II:

(SEQ ID NO: 17) X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²-X¹³-X¹⁴- GPVPTPPDN IQVQENF-X¹⁵-IS RIYGKWYNLA IGSTCPWLKK I- X¹⁶-DRMTVSTL VLGEGATEAE ISMTST-X¹⁷-WRK GVCEETSGAY EKTDTDGKFL YHKSKW-X¹⁸-ITM ESYVVHTNYD EY-AIFLTKKF SRHHGPTITA KLYGRAPQLR ETLLQDFRVV AQGVGIPEDS IFT- MADRGEC VPGEQEPEPI (formula II)

-   -   wherein at least one X is present and (in parentheses are         suggestions for further substitutions)     -   X¹ is absent or represents Met or N-formyl Met;     -   X² is absent or represents His;     -   X³ is absent or represents His;     -   X⁴ is absent or represents His;     -   X⁵ is absent or represents His;     -   X⁶ is absent or represents His;     -   X⁷ is absent or represents His;     -   X⁸ is absent or represents His;     -   X⁹ is absent or represents His;     -   X¹⁰ is absent or selected from Asp and Glu, Lys and Arg;     -   X¹¹ is absent or selected from Asp and Glu, Lys and Arg;     -   X¹² is absent or selected from Asp and Glu, Lys and Arg;     -   X¹³ is absent or selected from Asp and Glu, Lys and Arg;     -   X¹⁴ is absent or represents Lys or Glu, Asp or Arg or Met or         N-formyl Met;     -   X¹⁵ represents Asp or Asn or Glu;     -   X¹⁶ represents Met or Lys or Arg;     -   X¹⁷ represents Arg or His or Lys;     -   X¹⁸ represents Asp or Asn or Glu;     -   or a pharmaceutically acceptable salt thereof,     -   with the proviso that when all X¹-X¹⁴ are absent, X¹⁵ represents         Asn, X¹⁶ represents Met, and X¹⁷ represents Arg, then X¹⁸ cannot         represent Asn.

The invention also provides a derivative of A1M, i.e. X¹-X¹⁴-A1M, wherein A1M may be any A1M obtained from the species mentioned in Table 2 (i.e. human, mouse, naked mole-rat, frog, chicken, rabbit, squirrel monkey, walrus, manatee, plaice and orangutan), wherein A1M is truncated C-terminally, so that the C-terminal tetrapeptide sequence LIPR does not form part of the protein.

As it appears from the Examples herein, the present inventors have found that:

-   -   i) The initial sequence X¹-X¹⁴ seems to impart improved         properties to A1M,     -   ii) Point mutation M41K, R66H or N17,96D of the A1M molecule         imparts improved stability with maintained function of A1M,     -   iii) Mutations (M41K+R66H), (M41K+N17,96D), (R66H+N17,96D),         and/or (M41K+R66H+N17,96D) show increased solubility and/or         stability with maintained function,     -   iv) Mutation (R66H+N17,96D) had best overall performance in the         experiments performed,     -   v) A1M with mutations (R66H+N17,96D) and initial sequences         MHHHHHHHHGGGGGIEGR (M8H5GIEGR) (SEQ ID NO: 96); MHHHHHHHHDDDDK         (M8H4DK) (SEQ ID NO: 97), MHHHHHHDDDDK (M6H4DK) (SEQ ID NO: 98)         or MHHHHHHHH (M8H) (SEQ ID NO: 99) as N-terminal sequences have         been tested, and the protein variants with M8H4DK as N-terminal         sequence showed higher solubility and/or stability compared with         the other N-terminal extensions.     -   vi) Truncation of the C-terminal of A1M seems to impart improved         heme binding and degradation.

It is interesting to note that this N-terminal extension sequence resembles a His-tag with an enterokinase cleavage site, but it is without the ability to cleave the His-tag from A1M as the amino acid Ala is not included. The presence of Ala in a DDDKA (SEQ ID NO: 100) indicate the enterokinase cleavage site. Thus, it is contemplated that the N-terminal sequence itself imparts improved protein stability and solubility properties to A1M when the repeated His-residues are followed by five charged amino acids.

Based on these observations, it is contemplated that variation of an A1M protein along the lines indicated above will provide proteins with A1M functionality, but with improved characteristics regarding stability and/or solubility.

Thus, the present invention relates to all possible combinations of A1M containing X¹-X¹⁸ as described above.

More specifically, the following A1M derived proteins are within the scope of the present invention, such that the all proteins may be full-length corresponding to human wild type A1M; or may be truncated C-terminally, i.e. without LIPR (SEQ ID NO: 101) (“6-His” disclosed as SEQ ID NO: 102 and “8-His” disclosed as SEQ ID NO: 103):

Position in hA1M Tag Mutations Compound X1 X2 X3 X4 Broadest claim 1 Met/Absent His/absent His/absent His/absent 6-His ‘in sequence’ mutations can be any 2 (f)Met His His His 8-His in sequence’ mutations can be any 3 (f)Met His His His No tag; in sequence’ mutations can be any 4 Absent Absent Absent Absent Any tag M41K 5 Met/Absent His/absent His/absent His/absent Any tag N17, 96D 6 Met/Absent His/absent His/absent His/absent No tag N17D 7 Absent Absent Absent Absent No tag N17, 96D 8 Absent Absent Absent Absent No tag N96D 9 Absent Absent Absent Absent No tag N17, 96D, R66H 10 Absent Absent Absent Absent No tag M41K 11 Absent Absent Absent Absent No tag R66H 12 Absent Absent Absent Absent No tag N17, 96D, M41K, R66H 13 Absent Absent Absent Absent No tag N17D, R66H 14 Absent Absent Absent Absent No tag R66H, N96D 15 Absent Absent Absent Absent No tag M41K, R66H 16 Absent Absent Absent Absent No tag N17, 96D, M41K 17 Absent Absent Absent Absent No tag N17D, M41K 18 Absent Absent Absent Absent No tag M41K, N96D 19 Absent Absent Absent Absent Any tag N17, 96D, R66H 20 Met/Absent His/absent His/absent His/absent No tag N17D, M41K, R66H 21 Absent Absent Absent Absent No tag M41K, R66H, N96D 22 Absent Absent Absent Absent 6His N17D 23 (f)Met His His His 6His N17, 96D 24 (f)Met His His His 6His N96D 25 (f)Met His His His 6His N17, 96D, R66H 26 (f)Met His His His 6His M41K 27 (f)Met His His His 6His R66H 28 (f)Met His His His 6His N17, 96D, M41K, R66H 29 (f)Met His His His 6His N17D, R66H 30 (f)Met His His His 6His R66H, N96D 31 (f)Met His His His 6His M41K, R66H 32 (f)Met His His His 6His N17, 96D, M41K 33 (f)Met His His His 6His N17D, M41K 34 (f)Met His His His 6His M41K, N96D 35 (f)Met His His His 6His N17D, M41K, R66H 36 (f)Met His His His 6His M41K, R66H, N96D 37 (f)Met His His His 8His N17D 38 (f)Met His His His 8His N17, 96D 39 (f)Met His His His 8His N96D 40 (f)Met His His His 8His N17, 96D, R66H 41 (f)Met His His His 8His M41K 42 (f)Met His His His 8His R66H 43 (f)Met His His His 8His N17, 96D, M41K, R66H 44 (f)Met His His His 8His N17D, R66H 45 (f)Met His His His 8His R66H, N96D 46 (f)Met His His His 8His M41K, R66H 47 (f)Met His His His 8His N17, 96D, M41K 48 (f)Met His His His 8His N17D, M41K 49 (f)Met His His His 8His M41K, N96D 50 (f)Met His His His 8His N17D, M41K, R66H 51 (f)Met His His His 8His M41K, R66H, N96D 52 (f)Met His His His Position in hA1M Con'd N-terminal ‘tag’ Tag Mutations Compound X5 X6 X7 X8 X9 X10 Broadest claim 1 His/absent His/absent His/absent His/absent His/absent Asp/absent/ Glu/Lys/Arg 6-His ‘in sequence’ mutations can be any 2 His His His Absent Absent Asp 8-His in sequence’ mutations can be any 3 His His His His His Asp No tag; in sequence’ mutations can be any 4 Absent Absent Absent Absent Absent Absent Any tag M41K 5 His/absent His/absent His/absent His/absent His/absent Asp/absent/ Glu/Lys/Arg Any tag N17, 96D 6 His/absent His/absent His/absent His/absent His/absent Asp/absent/ Glu/Lys/Arg No tag N17D 7 Absent Absent Absent Absent Absent Absent No tag N17, 96D 8 Absent Absent Absent Absent Absent Absent No tag N96D 9 Absent Absent Absent Absent Absent Absent No tag N17, 96D, R66H 10 Absent Absent Absent Absent Absent Absent No tag M41K 11 Absent Absent Absent Absent Absent Absent No tag R66H 12 Absent Absent Absent Absent Absent Absent No tag N17, 96D, M41K, R66H 13 Absent Absent Absent Absent Absent Absent No tag N17D, R66H 14 Absent Absent Absent Absent Absent Absent No tag R66H, N96D 15 Absent Absent Absent Absent Absent Absent No tag M41K, R66H 16 Absent Absent Absent Absent Absent Absent No tag N17, 96D, M41K 17 Absent Absent Absent Absent Absent Absent No tag N17D, M41K 18 Absent Absent Absent Absent Absent Absent No tag M41K, N96D 19 Absent Absent Absent Absent Absent Absent Any tag N17, 96D, R66H 20 His/absent His/absent His/absent His/absent His/absent Asp/absent/ Glu/Lys/Arg No tag N17D, M41K, R66H 21 Absent Absent Absent Absent Absent Absent No tag M41K, R66H, N96D 22 Absent Absent Absent Absent Absent Absent 6His N17D 23 His His His Absent Absent Asp 6His N17, 96D 24 His His His Absent Absent Asp 6His N96D 25 His His His Absent Absent Asp 6His N17, 96D, R66H 26 His His His Absent Absent Asp 6His M41K 27 His His His Absent Absent Asp 6His R66H 28 His His His Absent Absent Asp 6His N17, 96D, M41K, R66H 29 His His His Absent Absent Asp 6His N17D, R66H 30 His His His Absent Absent Asp 6His R66H, N96D 31 His His His Absent Absent Asp 6His M41K, R66H 32 His His His Absent Absent Asp 6His N17, 96D, M41K 33 His His His Absent Absent Asp 6His N17D, M41K 34 His His His Absent Absent Asp 6His M41K, N96D 35 His His His Absent Absent Asp 6His N17D, M41K, R66H 36 His His His Absent Absent Asp 6His M41K, R66H, N96D 37 His His His Absent Absent Asp 8His N17D 38 His His His His His Asp 8His N17, 96D 39 His His His His His Asp 8His N96D 40 His His His His His Asp 8His N17, 96D, R66H 41 His His His His His Asp 8His M41K 42 His His His His His Asp 8His R66H 43 His His His His His Asp 8His N17, 96D, M41K, R66H 44 His His His His His Asp 8His N17D, R66H 45 His His His His His Asp 8His R66H, N96D 46 His His His His His Asp 8His M41K, R66H 47 His His His His His Asp 8His N17, 96D, M41K 48 His His His His His Asp 8His N17D, M41K 49 His His His His His Asp 8His M41K, N96D 50 His His His His His Asp 8His N17D, M41K, R66H 51 His His His His His Asp 8His M41K, R66H, N96D 52 His His His His His Asp Position in hA1M Con'd Tag Mutations Compound X11 X12 X13 Broadest claim 1 Asp/absent/Glu/Lys/Arg Asp/absent/Glu/Lys/Arg Asp/absent/Glu/Lys/Arg 6-His ‘in sequence’ mutations can be any 2 Asp Asp Asp 8-His in sequence’ mutations can be any 3 Asp Asp Asp No tag; in sequence’ mutations can be any 4 Absent Absent Absent Any tag M41K 5 Asp/absent/Glu/Lys/Arg Asp/absent/Glu/Lys/Arg Asp/absent/Glu/Lys/Arg Any tag N17, 96D 6 Asp/absent/Glu/Lys/Arg Asp/absent/Glu/Lys/Arg Asp/absent/Glu/Lys/Arg No tag N17D 7 Absent Absent Absent No tag N17, 96D 8 Absent Absent Absent No tag N96D 9 Absent Absent Absent No tag N17, 96D, R66H 10 Absent Absent Absent No tag M41K 11 Absent Absent Absent No tag R66H 12 Absent Absent Absent No tag N17, 96D, M41K, R66H 13 Absent Absent Absent No tag N17D, R66H 14 Absent Absent Absent No tag R66H, N96D 15 Absent Absent Absent No tag M41K, R66H 16 Absent Absent Absent No tag N17, 96D, M41K 17 Absent Absent Absent No tag N17D, M41K 18 Absent Absent Absent No tag M41K, N96D 19 Absent Absent Absent Any tag N17, 96D, R66H 20 Asp/absent/Glu/Lys/Arg Asp/absent/Glu/Lys/Arg Asp/absent/Glu/Lys/Arg No tag N17D, M41K, R66H 21 Absent Absent Absent No tag M41K, R66H, N96D 22 Absent Absent Absent 6His N17D 23 Asp Asp Asp 6His N17, 96D 24 Asp Asp Asp 6His N96D 25 Asp Asp Asp 6His N17, 96D, R66H 26 Asp Asp Asp 6His M41K 27 Asp Asp Asp 6His R66H 28 Asp Asp Asp 6His N17, 96D, M41K, R66H 29 Asp Asp Asp 6His N17D, R66H 30 Asp Asp Asp 6His R66H, N96D 31 Asp Asp Asp 6His M41K, R66H 32 Asp Asp Asp 6His N17, 96D, M41K 33 Asp Asp Asp 6His N17D, M41K 34 Asp Asp Asp 6His M41K, N96D 35 Asp Asp Asp 6His N17D, M41K, R66H 36 Asp Asp Asp 6His M41K, R66H, N96D 37 Asp Asp Asp 8His N17D 38 Asp Asp Asp 8His N17, 96D 39 Asp Asp Asp 8His N96D 40 Asp Asp Asp 8His N17, 96D, R66H 41 Asp Asp Asp 8His M41K 42 Asp Asp Asp 8His R66H 43 Asp Asp Asp 8His N17, 96D, M41K, R66H 44 Asp Asp Asp 8His N17D, R66H 45 Asp Asp Asp 8His R66H, N96D 46 Asp Asp Asp 8His M41K, R66H 47 Asp Asp Asp 8His N17, 96D, M41K 48 Asp Asp Asp 8His N17D, M41K 49 Asp Asp Asp 8His M41K, N96D 50 Asp Asp Asp 8His N17D, M41K, R66H 51 Asp Asp Asp 8His M41K, R66H, N96D 52 Asp Asp Asp Position in hA1M Con'd tag′/first AA 17 41 66 96 Tag Mutations Compound X14 X15 X16 X17 X18 Broadest claim 1 Lys/(f)Met/Absent/ Asp/Asn Met/Lys/Arg Arg/His/Lys Asp/Asn Glu/Asp/Arg 6-His ‘in sequence’ mutations can be any 2 Lys Asp/Asn Met/Lys/Arg Arg/His/Lys Asp/Asn 8-His in sequence’ mutations can be any 3 Lys Asp/Asn Met/Lys/Arg Arg/His/Lys Asp/Asn No tag; in sequence’ mutations can be any 4 Absent Asp/Asn Met/Lys/Arg Arg/His/Lys Asp/Asn Any tag M41K 5 Lys/(f)Met/Absent/ Asn Lys Arg Asn Glu/Asp/Arg Any tag N17, 96D 6 Lys/(f)Met/Absent Asp Met Arg Asp Glu/Asp/Arg No tag N17D 7 (f)Met Asp Met Arg Asn No tag N17, 96D 8 (f)Met Asp Met Arg Asp No tag N96D 9 (f)Met Asn Met Arg Asp No tag N17, 96D, R66H 10 (f)Met Asp Met His Asp No tag M41K 11 (f)Met Asn Lys Arg Asn No tag R66H 12 (f)Met Asp Met His Asn No tag N17, 96D, M41K, R66H 13 (f)Met Asp Lys His Asp No tag N17D, R66H 14 (f)Met Asp Met His Asn No tag R66H, N96D 15 (f)Met Asn Met His Asp No tag M41K, R66H 16 (f)Met Asn Lys His Asn No tag N17, 96D, M41K 17 (f)Met Asp Lys Arg Asp No tag N17D, M41K 18 (f)Met Asp Lys Arg Asn No tag M41K, N96D 19 (f)Met Asn Lys Arg Asp Any tag N17, 96D, R66H 20 Lys/(f)Met/Absent Asp Met His Asp Glu/Asp/Arg No tag N17D, M41K, R66H 21 (f)Met Asp Lys His Asn No tag M41K, R66H, N96D 22 (f)Met Asn Lys His Asp 6His N17D 23 Lys Asp Met Arg Asn 6His N17, 96D 24 Lys Asp Met Arg Asp 6His N96D 25 Lys Asn Met Arg Asp 6His N17, 96D, R66H 26 Lys Asp Met His Asp 6His M41K 27 Lys Asn Lys Arg Asn 6His R66H 28 Lys Asn Met His Asn 6His N17, 96D, M41K, R66H 29 Lys Asp Lys His Asp 6His N17D, R66H 30 Lys Asp Met His Asn 6His R66H, N96D 31 Lys Asn Met His Asp 6His M41K, R66H 32 Lys Asn Lys His Asn 6His N17, 96D, M41K 33 Lys Asp Lys Arg Asp 6His N17D, M41K 34 Lys Asp Lys Arg Asn 6His M41K, N96D 35 Lys Asn Lys Arg Asp 6His N17D, M41K, R66H 36 Lys Asp Lys His Asn 6His M41K, R66H, N96D 37 Lys Asn Lys His Asp 8His N17D 38 Lys Asp Met Arg Asn 8His N17, 96D 39 Lys Asp Met Arg Asp 8His N96D 40 Lys Asn Met Arg Asp 8His N17, 96D, R66H 41 Lys Asp Met His Asp 8His M41K 42 Lys Asn Lys Arg Asn 8His R66H 43 Lys Asn Met His Asn 8His N17, 96D, M41K, R66H 44 Lys Asp Lys His Asp 8His N17D, R66H 45 Lys Asp Met His Asn 8His R66H, N96D 46 Lys Asn Met His Asp 8His M41K, R66H 47 Lys Asn Lys His Asn 8His N17, 96D, M41K 48 Lys Asp Lys Arg Asp 8His N17D, M41K 49 Lys Asp Lys Arg Asn 8His M41K, N96D 50 Lys Asn Lys Arg Asp 8His N17D, M41K, R66H 51 Lys Asp Lys His Asn 8His M41K, R66H, N96D 52 Lys Asn Lys His Asp Position in hA1M Con'd Tag Mutations Compound Comment Broadest claim 1 Proviso: when all X1-X14 are absent, X15 represents Asn, X16 represents 6-His ‘in sequence’ mutations can be any 2 Met, and X17 represents Arg, then X18 cannot represent Asn. 8-His in sequence’ mutations can be any 3 No tag; in sequence’ mutations can be any 4 Proviso: when X15 represents Asn, X16 represents Met, Any tag M41K 5 and X17 represents Arg, then X18 cannot represent Asn Any tag N17, 96D 6 No tag N17D 7 No tag N17, 96D 8 No tag N96D 9 No tag N17, 96D, R66H 10 Preferred mutation without tag No tag M41K 11 No tag R66H 12 No tag N17, 96D, M41K, R66H 13 All mutations No tag N17D, R66H 14 No tag R66H, N96D 15 No tag M41K, R66H 16 No tag N17, 96D, M41K 17 No tag N17D, M41K 18 No tag M41K, N96D 19 Any tag N17, 96D, R66H 20 No tag N17D, M41K, R66H 21 No tag M41K, R66H, N96D 22 6His N17D 23 6His N17, 96D 24 6His N96D 25 6His N17, 96D, R66H 26 Preferred mutation with 6His 6His M41K 27 6His R66H 28 6His N17, 96D, M41K, R66H 29 6His N17D, R66H 30 6His R66H, N96D 31 6His M41K, R66H 32 6His N17, 96D, M41K 33 6His N17D, M41K 34 6His M41K, N96D 35 6His N17D, M41K, R66H 36 6His M41K, R66H, N96D 37 8His N17D 38 8His N17, 96D 39 8His N96D 40 8His N17, 96D, R66H 41 Preferred mutation with 8His 8His M41K 42 8His R66H 43 8His N17, 96D, M41K, R66H 44 8His N17D, R66H 45 8His R66H, N96D 46 8His M41K, R66H 47 8His N17, 96D, M41K 48 8His N17D, M41K 49 8His M41K, N96D 50 8His N17D, M41K, R66H 51 8His M41K, R66H, N96D 52

Alpha-1-Microglobulin—a General Background

A1M is synthesized in the liver at a high rate, secreted into the blood stream and transported across the vessel walls to the extravascular compartment of all organs. The protein is also synthesized in other tissues (blood cells, brain, kidney, skin) but at a lower rate. Due to the small size, free A1M is rapidly filtered from blood in the kidneys.

A1M is a member of the lipocalin superfamily, a group of proteins from animals, plants and bacteria with a conserved three-dimensional structure but very diverse functions. Each lipocalin consists of a 160-190-amino acid chain that is folded into a 1-barrel pocket with a hydrophobic interior. At least twelve human lipocalin genes are known. A1M is a 26 kDa plasma and tissue protein that so far has been identified in mammals, birds, fish and frogs. The three-dimensional structure of A1M determined by X-ray crystallography is shown in FIG. 10. A1M is synthesized in the liver at a high rate, secreted into the blood stream and rapidly (T½=2-3 min) transported across the vessel walls to the extravascular compartment of all organs. A1M is found both in a free, monomeric form and as covalent complexes with larger molecules (IgA, albumin, prothrombin) in blood and interstitial tissues. Due to the small size, free A1M is rapidly filtered from blood in the kidneys. The major portion is then readsorbed, but significant amounts are excreted to the urine.

Antioxidants are protective factors that eliminate oxidants or prevent harmful oxidation reactions. The human organism can produce antioxidants in response to oxidative stress. Such endogenous antioxidants include the superoxide-degrading enzyme superoxide dismutase (SOD), the hydrogen peroxide-degrading enzymes catalase and glutathione peroxidase, and the heme-degrading enzyme heme oxygenase-1 (HO-1). A1M was recently shown to be involved in protecting against oxidative tissue damage by functioning both as a scavenger of radicals and heme as well as a reductase and inhibitor of oxidation. Several recent papers demonstrate that A1M protects cell cultures and organ explants against oxidative damage, partly by accumulating in mitochondria and protecting mitochondrial function. Indeed, infusion of human recombinant A1M has been successfully employed for in vivo treatment of the oxidative stress-related diseases preeclampsia and hemoglobin-induced glomerular injuries in animal models.

Sequence and Structural Properties of A1M

The full sequence of human A1M is known. The protein consists of a polypeptide with 183 amino acid residues. Many additional A1M cDNAs and/or proteins have been detected, isolated and/or sequenced from other mammals, birds, amphibians, and fish. The length of the peptide chain of A1M differs slightly among species, due mainly to variations in the C-terminus. Alignment comparisons of the different deduced amino acid sequences show that the percentage of identity varies from approximately 75-80% between rodents or ferungulates and man, down to approximately 45% between fish and mammals. A free cysteine side-chain at position 34 is conserved. This group has been shown to be involved in redox reactions (see below), in complex formation with other plasma proteins and in binding to a yellow-brown chromophore. The three-dimensional structure of A1M shows that C34 is solvent exposed and located near the opening of the lipocalin pocket (see FIG. 10).

In the present context the term “al-microglobulin” intends to cover α₁-microglobulin as identified in SEQ ID NO: 1 (human A1M), SEQ ID NO: 2 (human recombinant A1M) and A1M from other species, including homologues, fragments or variants thereof having similar therapeutic activities. Thus, A1M as used herein is intended to mean a protein having at least 80% sequence identity with SEQ ID NO:1 or SEQ ID NO:2. It is preferred that A1M as used herein has at least 90% sequence identity with SEQ ID NO:1 or SEQ ID NO:2. It is even more preferred that A1M as used herein has at least 95% such as 99% or 100% sequence identity with SEQ ID NO:1 or SEQ ID NO:2. In a preferred aspect, the α₁-microglobulin is in accordance with SEQ ID NO: 1 or 2 as identified herein. In the sequence listing the amino acid sequences of human A1M and human recombinant A1M (SEQ ID NOs 1 and 2, respectively) are given. However, homologues, variants and fragments of A1M having the important parts of the proteins as identified in the following are also comprised in the term A1M as used herein. Regarding alignments/identity see the following paragraph.

Details on Alignment/Identity

Positions of amino acid residues herein refer to the positions in human wt A1M as it is found in human blood plasma (SEQ ID NO:1). When referring to amino acid residues in recombinant A1M, which harbors a methionine or N-formyl methionine residue N-terminally linked to the glycine residue that is the initial residue in wt-A1M (SEQ ID NO: 2), or in mutated human A1M or A1M from other species a person skilled in the art will understand how to identify residues corresponding to residues in human wt-A1M (SEQ ID NO:1) even when positions are shifted due to e.g. deletions or insertions.

When recombinant proteins are produced they most often start with an initial Met residue, which may be removed using e.g. a methionine aminopeptidase or another enzyme with a similar activity. The A1M variants presented here may be with or without an initial Met residue.

Homologues of A1M

As mentioned above homologues of A1M can also be used in accordance with the description herein. In theory A1M from all species can be used for the purposes described herein including the most primitive found so far, which is from fish (plaice). A1M is also available in isolated form from human, orangutan, squirrel monkey, rat, naked mole rat, mouse, rabbit, guinea pig, cow, frog, chicken, walrus, manatee and plaice.

Considering homologues, variants and fragments of A1M, the following has been identified as important parts of the protein for the anti-oxidative effect:

Y22 (Tyrosine, pos 22, basepairs 64-66)

C34 (Cystein, position 34, basepairs 100-102)

K69 (Lysine, pos 69, basepairs 205-207)

K92 (Lysine, pos 92, basepairs 274-276)

K118 (Lysine, pos 118, basepairs 352-354)

K130 (Lysine, pos 130, basepairs 388-390)

Y132 (Tyrosine, pos 132, basepairs 394-396)

L180 (Leucine, pos 180, basepairs 538-540)

I181 (Isoleucine, pos 181, basepairs 541-543)

P182 (Proline, pos 182, basepairs 544-546)

R183 (Arginine, pos 183, basepairs 547-549)

Numbering of amino acids and nucleotides throughout the document refers to SEQ ID 1; if other A1M from other species, A1M analogs or recombinant sequences thereof are employed, a person skilled in the art will know how to identify the amino acids corresponding to the amino acids in SEQ ID NO: 1.

Thus, in those cases, where A1M eg has 80% (or 90% or 95%) sequence identity with one of SEQ ID NO: 1 or 2, it is preferred that the amino acids mentioned above are present at the appropriate places in the molecule.

Human A1M is substituted with oligosaccharides in three positions, two sialylated complex-type, probably diantennary carbohydrated linked to N17 and N96 and one more simple oligosaccharide linked to T5. The carbohydrate content of A1M proteins from different species varies greatly, though, ranging from no glycosylation at all in Xenopus leavis over a spectrum of different glycosylation patterns. However, one glycosylation site, corresponding to N96 in man, is conserved in mammals, suggesting that this specific carbohydrate may be a more important constituent of the protein than the other two oligosaccharides.

A1M is yellow-brown-coloured when purified from plasma or urine. The colour is caused by heterogeneous compounds covalently bound to various amino acid side groups mainly located at the entrance to the pocket. These modifications represent the oxidized degradation products of organic oxidants covalently trapped by A1M in vivo, for example heme, kynurenine and tyrosyl radicals.

A1M is also charge- and size-heterogeneous and more highly brown-coloured A1M-molecules are more negatively charged. The probable explanation for the heterogeneity is that different side-groups are modified to a varying degree with different radicals, and that the modifications alter the net charge of the protein. Covalently linked coloured substances have been localized to C34, and K92, K118 and K130, the latter with molecular masses between 100 and 300 Da. The tryptophan metabolite kynurenine was found covalently attached to lysyl residues in A1M from urine of haemodialysis patients and appears to be the source of the brown colour of the protein in this case [6]. Oxidized fragments of the synthetic radical ABTS (2,2′-azino-di-(3-ethylbenzothiazoline)-6-sulfonic acid) was bound to the side-chains of Y22 and Y132.

C34 is the reactive center of A1M. It becomes very electronegative, meaning that it has a high potential to give away electrons, by the proximity of the positively charged side-chains of K69, K92, K118 and K130, which induce a deprotonization of the C34 thiol group which is a prerequisite of oxidation of the sulphur atom. Preliminary data shows that C34 is one of the most electronegative groups known.

Theoretically, the amino acids that characterize the properties of A1M (C34, Y22, K92, K118, K130, Y132, L180, I181, P182, R183), which will be described in more detail below, can be arranged in a similar three-dimensional configuration on another framework, for instance a protein with the same global folding (another lipocalin) or a completely artificial organic or inorganic molecule such as a plastic polymer, a nanoparticle or metal polymer.

The three-dimensional arrangement of some of these amino acids (blue ovals, the lysines are depicted by a “+”), the A1M-framework (barrel), the electron-flow and the radical-trapping, are illustrated in FIG. 10.

Accordingly, homologues, fragments or variants comprising a structure including the reactive centre and its surroundings as depicted above, are preferred.

Modifications and changes have been made in the structure of the polypeptides of this disclosure and still resulted in a molecule having similar functional characteristics as the original polypeptide (e.g., a conservative amino acid substitution). For example, certain amino acids can be substituted for other amino acids in a sequence without appreciable loss of activity. Because it is the interactive capacity and nature of a polypeptide that defines that polypeptide's biological functional activity, certain amino acid sequence substitutions can be made in a polypeptide sequence and nevertheless obtain a polypeptide with like functional properties.

In making such changes, the hydropathic index of amino acids can be considered. The importance of the hydropathic amino acid index in conferring interactive biologic function on a polypeptide is generally understood in the art. It is known that certain amino acids can be substituted for other amino acids having a similar hydropathic index or score and still result in a polypeptide with similar biological activity. Each amino acid has been assigned a hydropathic index on the basis of its hydrophobicity and charge characteristics. Those indices are: isoleucine (+4.5); valine (+4.2); leucine (+3.8); phenylalanine (+2.8); cysteine/cysteine (+2.5); methionine (+1.9); alanine (+1.8); glycine (0.4); threonine (−0.7); serine (−0.8); tryptophan (−0.9); tyrosine (−1.3); proline (−1.6); histidine (−3.2); glutamate (−3.5); glutamine (−3.5); aspartate (−3.5); asparagine (−3.5); lysine (−3.9); and arginine (−4.5).

It is believed that the relative hydropathic character of the amino acid determines the secondary structure of the resultant polypeptide, which in turn defines the interaction of the polypeptide with other molecules, such as enzymes, substrates, receptors, antibodies, antigens, and the like. It is known in the art that an amino acid can be substituted by another amino acid having a similar hydropathic index and still obtain a functionally equivalent polypeptide. In such changes, the substitution of amino acids whose hydropathic indices are within ±2 is preferred, those within ±1 are particularly preferred, and those within ±0.5 are even more particularly preferred.

Substitution of like amino acids can also be made on the basis of hydrophilicity, particularly where the biologically functional equivalent polypeptide or peptide thereby created is intended for use in immunological embodiments. The following hydrophilicity values have been assigned to amino acid residues: arginine (+3.0); lysine (+3.0); aspartate (+3.0±1); glutamate (+3.0±1); serine (+0.3); asparagine (+0.2); glutamine (+0.2); glycine (0); proline (−0.5±1); threonine (−0.4); alanine (−0.5); histidine (−0.5); cysteine (1.0); methionine (−1.3); valine (−1.5); leucine (−1.8); isoleucine (−1.8); tyrosine (−2.3); phenylalanine (−2.5); tryptophan (−3.4). It is understood that an amino acid can be substituted for another having a similar hydrophilicity value and still obtain a biologically equivalent, and in particular, an immunologically equivalent polypeptide. In such changes, the substitution of amino acids the hydrophilicity values of which are within ±2 is preferred, those within ±1 are particularly preferred, and those within ±0.5 are even more particularly preferred.

As outlined above, amino acid substitutions are generally based on the relative similarity of the amino acid side-chain substituents, for example, their hydrophobicity, hydrophilicity, charge, size, and the like. Exemplary substitutions that take one or more of the foregoing characteristics into consideration are well known to those of skill in the art and include, but are not limited to (original residue: exemplary substitution): (Ala: Gly, Ser), (Arg: Lys), (Asn: Gln₁ His), (Asp: Glu, Cys, Ser), (Gln: Asn), (Glu: Asp), (Gly: Ala), (His: Asn, Gin), (Ile: Leu, Val), (Leu: lie, Val), (Lys: Arg), (Met: Leu, Tyr), (Ser: Thr), (Thr: Ser), (Trp: Tyr), (Tyr: Trp, Phe), and (Val: Lie, Leu). Embodiments of this disclosure thus contemplate functional or biological equivalents of a polypeptide as set forth above. In particular, embodiments of the polypeptides can include variants having about 50%, 60%, 70%, 80%, 90%, and 95% sequence identity to the polypeptide of interest.

In the present context, the homology between two amino acid sequences or between two nucleic acid sequences is described by the parameter “identity” (see also above). Alignments of sequences and calculation of homology scores may be done using a full Smith-Waterman alignment, useful for both protein and DNA alignments. The default scoring matrices BLOSUM50 and the identity matrix are used for protein and DNA alignments respectively. The penalty for the first residue in a gap is −12 for proteins and −16 for DNA, while the penalty for additional residues in a gap is −2 for proteins and −4 for DNA. Alignment may be made with the FASTA package version v20u6.

Multiple alignments of protein sequences may be made using “ClustalW”. Multiple alignments of DNA sequences may be done using the protein alignment as a template, replacing the amino acids with the corresponding codon from the DNA sequence.

Alternatively different software can be used for aligning amino acid sequences and DNA sequences. The alignment of two amino acid sequences is e.g. determined by using the Needle program from the EMBOSS package (http://emboss.org) version 2.8.0. The Needle program implements the global alignment algorithm described in. The substitution matrix used is BLOSUM62, gap opening penalty is 10, and gap extension penalty is 0.5.

The degree of identity between an amino acid sequence; e.g. SEQ ID NO: 1 and a different amino acid sequence (e.g. SEQ ID NO: 2) is calculated as the number of exact matches in an alignment of the two sequences, divided by the length of the “SEQ ID NO: 1” or the length of the “SEQ ID NO: 2”, whichever is the shortest. The result is expressed in percent identity. See above regarding alignment and identity.

An exact match occurs when the two sequences have identical amino acid residues in the same positions of the overlap.

If relevant, the degree of identity between two nucleotide sequences can be determined by the Wilbur-Lipman method using the LASER-GENE™ MEGALIGN™ software (DNASTAR, Inc., Madison, Wis.) with an identity table and the following multiple alignment parameters: Gap penalty of 10 and gap length penalty of 10. Pairwise alignment parameters are Ktuple=3, gap penalty=3, and windows=20.

The percentage of identity of an amino acid sequence of a polypeptide with, or to, amino acids of SEQ ID NO: 1 may be determined by i) aligning the two amino acid sequences using the Needle program, with the BLOSUM62 substitution matrix, a gap opening penalty of 10, and a gap extension penalty of 0.5; ii) counting the number of exact matches in the alignment; iii) dividing the number of exact matches by the length of the shortest of the two amino acid sequences, and iv) converting the result of the division of iii) into percentage. The percentage of identity to, or with, other sequences of the invention is calculated in an analogous way.

By way of example, a polypeptide sequence may be identical to the reference sequence, that is be 100% identical, or it may include up to a certain integer number of amino acid alterations as compared to the reference sequence such that the % identity is less than 100%. Such alterations are selected from: at least one amino acid deletion, substitution (including conservative and non-conservative substitution), or insertion, and wherein said alterations may occur at the amino- or carboxy-terminus positions of the reference polypeptide sequence or anywhere between those terminal positions, interspersed either individually among the amino acids in the reference sequence, or in one or more contiguous groups within the reference sequence.

Conservative amino acid variants can also comprise non-naturally occurring amino acid residues. Non-naturally occurring amino acids include, without limitation, trans-3-methylproline, 2,4-methanoproline, cis-4-hydroxyproline, trans-4-hydroxyproline, N-methyl-glycine, allo-threonine, methylthreonine, hydroxy-ethylcysteine, hydroxyethylhomocysteine, nitro-glutamine, homoglutamine, pipecolic acid, thiazolidine carboxylic acid, dehydroproline, 3- and 4-methylpróline, 3,3-dimethylproline, tert-leucine, norvaline, 2-azaphenyl-alanine, 3-azaphenylalanine, 4-azaphenylalanine, and 4-fluorophenylalanine. Several methods are known in the art for incorporating non-naturally occurring amino acid residues into proteins. For example, an in vitro system can be employed wherein nonsense mutations are suppressed using chemically aminoacylated suppressor tRNAs. Methods for synthesizing amino acids and aminoacylating tRNA are known in the art. Transcription and translation of plasmids containing nonsense mutations is carried out in a cell-free system comprising an E. coli S30 extract and commercially available enzymes and other reagents. Proteins are purified by chromatography. In a second method, translation is carried out in Xenopus oocytes by microinjection of mutated mRNA and chemically aminoacylated suppressor tRNAs. Within a third method, E. coli cells are cultured in the absence of a natural amino acid that is to be replaced (e.g., phenylalanine) and in the presence of the desired non-naturally occurring amino acid(s) (e.g., 2-azaphenylalanine, 3-azaphenylalanine, 4-azaphenylalanine, or 4-fluorophenylalanine). The non-naturally occurring amino acid is incorporated into the protein in place of its natural counterpart. Naturally occurring amino acid residues can be converted to non-naturally occurring species by in vitro chemical modification. Chemical modification can be combined with site-directed mutagenesis to further expand the range of substitutions. Alternative chemical structures providing a 3-dimensional structure sufficient to support the antioxidative properties of A1M may be provided by other technologies e.g. artificial scaffolds, amino-acid substitutions and the like. Furthermore, structures mimicking the active sites of A1M as listed above are contemplated as having the same therapeutic or physiologic function as A1M.

Pharmaceutical Compositions and Dosage

The present invention also provides a kit comprising:

i) a pharmaceutical composition comprising a contrast medium, and

ii) a pharmaceutical composition comprising A1M, any of the SEQ ID Nos: 1-10 and 17, or any of the A1M derived proteins mentioned herein (or a mutant, analogue, fragment or variant as defined herein).

In the following a listing of the sequences are given. The invention encompass all possible variations eg such as those illustrated herein.

SEQ ID NO: 1: wt hA1M

SEQ ID NO: 2: rhA1M (i.e. Met-A1M)

SEQ ID NO: 3: Preferred mutation without “extension”—N17,96D, R66H

SEQ ID NO: 4: No extension, M41K

SEQ ID NO: 5: Preferred mutation with 6 His (SEQ ID NO: 102), N17,96D, R66H

SEQ ID NO: 6: 6His (SEQ ID NO: 102), M41K

SEQ ID NO: 7: preferred mutation with 8 His extension (SEQ ID NO: 103), N17,96D, R66H

SEQ ID NO: 8: 8 His (SEQ ID NO: 103), M41K

SEQ ID NO: 9: Extension+wt hA1M

SEQ ID NO: 10: Omnibus A1M with possible extensions.

SEQ ID NO: 11-16: segments of wt hA1M

SEQ ID NO: 17: Omnibus C-terminally truncated A1M with possible extensions

SEQ ID NO: 18: Preferred mutation without “extension”—N17,96D, R66; C-terminally truncated.

SEQ ID NO: 19: No extension, M41K; C-terminally truncated.

SEQ ID NO: 20: Preferred mutation with 6 His (SEQ ID NO: 102), N17,96D, R66H; C-terminally truncated.

SEQ ID NO: 21: 6His (SEQ ID NO: 102), M41K; C-terminally truncated.

SEQ ID NO: 22: preferred mutation with 8 His extension (SEQ ID NO: 103), N17,96D, R66H; C-terminally truncated.

SEQ ID NO: 23: 8 His (SEQ ID NO: 103), M41K; C-terminally truncated.

The kit is in the form of one package containing the above-mentioned two compositions.

The pharmaceutical composition comprising a contrast medium is typically a composition already on the market.

The pharmaceutical composition comprising A1M (or an analogue, fragment or variant thereof as defined herein) is intended for i.v. administration. Accordingly, A1M can be formulated in a liquid, e.g. in a solution, a dispersion, an emulsion, a suspension etc.

For parenteral use suitable solvents include water, vegetable oils, propylene glycol and organic solvents generally approved for such purposes. In general, a person skilled in the art can find guidance in “Remington's Pharmaceutical Science” edited by Gennaro et al. (Mack Publishing Company), in “Handbook of Pharmaceutical Excipients” edited by Rowe et al. (PhP Press) and in official Monographs (e.g. Ph.Eur. or USP) relating to relevant excipients for specific formulation types and to methods for preparing a specific formulation.

A1M will be administrated in one or several doses in connection to the administration of contrast medium. Preferably, each dose will be administrated i.v. either as a single dose, as a single dose followed by slow infusion during a short time-period up to 60 minutes, or only as a slow infusion during a short time-period up to 60 minutes. The first dose may be administrated at the same time as the contrast medium, or within a period of 0-60 minutes before to 0-30 minutes after injection of the contrast medium. Additional A1M-doses can be added, but may not be necessary, after injection of the contrast medium. Each dose contains an amount of A1M which is related to the bodyweight of the patient: 1-15 mg A1M/kg of the patient.

Sequence Listing Free Text SEQ ID NO: 1 <223> Wildtype human A1M, no mutations SEQ ID NO: 2 <223> rhA1M, ie N-terminal Met SEQ ID NO: 3 <223> hA1M, No tag, N-terminal Met, N17, 96D; R66H SEQ ID NO: 4 <223> hA1M, not tag, N-terminal Met, M41K SEQ ID NO: 5 <223> 6His, N17, 96D; R66H SEQ ID NO: 6 <223> hA1M, 6His, M41K SEQ ID NO: 7 <223> 8His, N17, 96D; R66H SEQ ID NO: 8 <223> hA1M, 8His, M41K SEQ ID NO: 9 <223> hA1M, 8His, no mut SEQ ID NO: 10 <211> 193 <212> PRT <213> Homo sapiens <220> <221> VARIANT <222> 1 <223> Xaa = Met or absent <220> <221> VARIANT <222> 1 <223> Xaa = Met or absent <220> <221> VARIANT <222> 2 <223> Xaa = His or absent <220> <221> VARIANT <222> 2 <223> Xaa = His or absent <220> <221> VARIANT <222> 3 <223> Xaa = His or absent <220> <221> VARIANT <222> 3 <223> Xaa = His or absent <220> <221> VARIANT <222> 4 <223> Xaa = His or absent <220> <221> VARIANT <222> 4 <223> Xaa = His or absent <220> <221> VARIANT <222> 5 <223> Xaa = His or absent <220> <221> VARIANT <222> 5 <223> Xaa = His or absent <220> <221> VARIANT <222> 6 <223> Xaa = His or absent <220> <221> VARIANT <222> 6 <223> Xaa = His or absent <220> <221> VARIANT <222> 7 <223> Xaa = His or absent <220> <221> VARIANT <222> 7 <223> Xaa = His or absent <220> <221> VARIANT <222> 8 <223> Xaa = His or absent <220> <221> VARIANT <222> 8 <223> Xaa = His or absent <220> <221> VARIANT <222> 9 <223> Xaa = His or absent <220> <221> VARIANT <222> 9 <223> Xaa = His or absent <220> <221> VARIANT <222> 10 <223> Xaa = Asp, Glu, Lys, Arg, or absent <220> <221> VARIANT <222> 10 <223> Xaa = Asp, Glu, Lys, Arg, or absent <220> <221> VARIANT <222> 11 <223> Xaa = Asp, Glu, Lys, Arg, or absent <220> <221> VARIANT <222> 11 <223> Xaa = Asp, Glu, Lys, Arg, or absent <220> <221> VARIANT <222> 12 <223> Xaa = Asp, Glu, Lys, Arg, or absent <220> <221> VARIANT <222> 12 <223> Xaa = Asp, Glu, Lys, Arg, or absent <220> <221> VARIANT <222> 13 <223> Xaa = Asp, Glu, Lys, Arg, or absent <220> <221> VARIANT <222> 13 <223> Xaa = Asp, Glu, Lys, Arg, or absent <220> <221> VARIANT <222> 14 <223> Xaa = Asp, Glu, Lys, Arg, or absent <220> <221> VARIANT <222> 14 <223> Xaa = Asp, Glu, Lys, Arg, or absent <220> <221> VARIANT <222> 31 <223> Xaa = Asn or Asp <220> <221> VARIANT <222> 55 <223> Xaa = Met or Lys <220> <221> VARIANT <222> 80 <223> Xaa = Arg or His <220> <221> VARIANT <222> 110 <223> Xaa = Asn or Asp SEQ ID NO: 11 <223> Y1 SEQ ID NO: 12 <223> Y2 SEQ ID NO: 13 <223> Y3 SEQ ID NO: 14 <223> Y4 SEQ ID NO: 15 <223> Y5 SEQ ID NO: 16 <223> Y5 SEQ ID NO: 17 <211> 197 <212> PRT <213> Homo sapiens <220> <221> VARIANT <222> 1 <223> Xaa = Met or absent <220> <221> VARIANT <222> 1 <223> Xaa = Met or absent <220> <221> VARIANT <222> 2 <223> Xaa = His or absent <220> <221> VARIANT <222> 2 <223> Xaa = His or absent <220> <221> VARIANT <222> 3 <223> Xaa = His or absent <220> <221> VARIANT <222> 3 <223> Xaa = His or absent <220> <221> VARIANT <222> 4 <223> Xaa = His or absent <220> <221> VARIANT <222> 4 <223> Xaa = His or absent <220> <221> VARIANT <222> 5 <223> Xaa = His or absent <220> <221> VARIANT <222> 5 <223> Xaa = His or absent <220> <221> VARIANT <222> 6 <223> Xaa = His or absent <220> <221> VARIANT <222> 6 <223> Xaa = His or absent <220> <221> VARIANT <222> 7 <223> Xaa = His or absent <220> <221> VARIANT <222> 7 <223> Xaa = His or absent <220> <221> VARIANT <222> 8 <223> Xaa = His or absent <220> <221> VARIANT <222> 8 <223> Xaa = His or absent <220> <221> VARIANT <222> 9 <223> Xaa = His or absent <220> <221> VARIANT <222> 9 <223> Xaa = His or absent <220> <221> VARIANT <222> 10 <223> Xaa = Asp, Glu, Lys, Arg, or absent <220> <221> VARIANT <222> 10 <223> Xaa = Asp, Glu, Lys, Arg, or absent <220> <221> VARIANT <222> 11 <223> Xaa = Asp, Glu, Lys, Arg, or absent <220> <221> VARIANT <222> 11 <223> Xaa = Asp, Glu, Lys, Arg, or absent <220> <221> VARIANT <222> 12 <223> Xaa = Asp, Glu, Lys, Arg, or absent <220> <221> VARIANT <222> 12 <223> Xaa = Asp, Glu, Lys, Arg, or absent <220> <221> VARIANT <222> 13 <223> Xaa = Asp, Glu, Lys, Arg, or absent <220> <221> VARIANT <222> 13 <223> Xaa = Asp, Glu, Lys, Arg, or absent <220> <221> VARIANT <222> 14 <223> Xaa = Asp, Glu, Lys, Arg, or absent <220> <221> VARIANT <222> 14 <223> Xaa = Asp, Glu, Lys, Arg, or absent <220> <221> VARIANT <222> 31 <223> Xaa = Asn or Asp <220> <221> VARIANT <222> 55 <223> Xaa = Met or Lys <220> <221> VARIANT <222> 80 <223> Xaa = Arg or His <220> <221> VARIANT <222> 110 <223> Xaa = Asn or Asp SEQ ID NO: 18 <223> hA1M, No tag, N-terminal Met, N17, 96D; R66H; truncated SEQ ID NO: 19 <223> hA1M, not tag, N-terminal Met, M41K; truncated SEQ ID NO: 20 <223> 6His (SEQ ID NO: 102), N17, 96D; R66H; truncated SEQ ID NO: 21 <223> hA1M, 6His (SEQ ID NO: 102), M41K; truncated SEQ ID NO: 22 <223> 8His (SEQ ID NO: 103), N17, 96D; R66H; truncated SEQ ID NO: 23 <223> hA1M, 8His (SEQ ID NO: 103), M41K; truncated SEQ ID NO: 24 <223> 1.M8H5GIEGR-Mouse SEQ ID NO: 25 <223> 2.M8H5GIEGR-Naked Mole rat SEQ ID NO: 26 <223> 3.M8H5GIEGR-Frog SEQ ID NO: 27 <223> 4.M8H5GIEGR-Chicken SEQ ID NO: 28 <223> 5.M8H5GIEGR-Rabbit SEQ ID NO: 29 <223> 6.M8H5GIEGR-SQ Monkey SEQ ID NO: 30 <223> 7.M8H5GIEGR-Walrus SEQ ID NO: 31 <223> 8.M8H5GIEGR-Manatee SEQ ID NO: 32 <223> 9. M8H5GIEGR-Plaice SEQ ID NO: 33 <223> 10.M8H5GIEGR-Orangutan SEQ ID NO: 34 <223> 11.M8H5GIEGR-Human P35K SEQ ID NO: 35 <223> 12.M8H5GIEGR-Human M41K SEQ ID NO: 36 .M8H5GIEGR-Human R66H SEQ ID NO: 37 <223> 14.M8H5GIEGR-Human T75K SEQ ID NO: 38 <223> 15.M8H5GIEGR-Human T75Y SEQ ID NO: 39 <223> 16.M8H5GIEGR-Human M99K SEQ ID NO: 40 <223> 17.M8H5GIEGR-Human S101Y SEQ ID NO: 41 <223> 18.M8H5GIEGR-Human K69.92.118.130R SEQ ID NO: 42 <223> 19.M8H5GIEGR-Coelacanth SEQ ID NO: 43 <223> 21.M8H5GIEGR-Human L89T SEQ ID NO: 44 <223> 22.M8H5GIEGR-Human N1796D SEQ ID NO: 45 <223> 23.M8H5GIEGR-Human T45K SEQ ID NO: 46 <223> 24.M8H5GIEGR-Human A135E SEQ ID NO: 47 <223> 25.M8H5GIEGR-Human V170S SEQ ID NO: 48 <223> 26.M8H5GIEGR-Human SEQ ID NO: 49 <223> 27.M8H5GIEGR-Human G172Q SEQ ID NO: 50 <223> 33.M8H4DK-Human M41K+ SEQ ID NO: 51 <223> 34.M8H4DK-Human M41K + N1796D 34 SEQ ID NO: 52 <223> 35.M8H4DK-Human R66H + N1796D SEQ ID NO: 53 <223> 36.M8H4DK-Human M41K + R66H + N1796D SEQ ID NO: 54 <223> 38.M8H4DK-Human R66H SEQ ID NO: 55 <223> 39.M8H4DK-Human SEQ ID NO: 56 <223> 40.M8H-Human wt SEQ ID NO: 57 <223> 41.M8H-Human R66H + N1796D SEQ ID NO: 58 <223> 60.M8H4DK-Human wt SEQ ID NO: 59 <223> 1.M8H5GIEGR-Mouse SEQ ID NO: 60 <223> 2.M8H5GIEGR-Naked Mole SEQ ID NO: 61 <223> 3.M8H5GIEGR-Frog SEQ ID NO: 62 <223> 4.M8H5GIEGR-Chicken SEQ ID NO: 63 <223> 5.M8H5GIEGR-Rabbit SEQ ID NO: 64 <223> 6.M8H5GIEGR-SQ Monkey SEQ ID NO: 65 <223> 7.M8H5GIEGR-Walrus SEQ ID NO: 66 <223> 8.M8H5GIEGR-Manatee SEQ ID NO: 67 <223> 9.M8H5GIEGR-Plaice SEQ ID NO: 68 <223> 10.M8H5GIEGR-Orangutan SEQ ID NO: 69 <223> 11.M8H5GIEGR-Human P35K SEQ ID NO: 70 <223> 12.M8H5GIEGR-Human M41K SEQ ID NO: 71 <223> 13.M8H5GIEGR-Human R66H SEQ ID NO: 72 <223> 14.M8H5GIEGR-Human T75K SEQ ID NO: 73 <223> 15.M8H5GIEGR-Human T75Y SEQ ID NO: 74 <223> 16.M8H5GIEGR-Human M99K SEQ ID NO: 75 <223> 17.M8H5GIEGR-Human S101Y SEQ ID NO: 76 <223> 18.M8H5GIEGR-Human K69.92.118. SEQ ID NO: 77 <223> 19.M8H5GIEGR-Coelacanth SEQ ID NO: 78 <223> 21.M8H5GIEGR-Human L89T SEQ ID NO: 79 <223> 22.M8H5GIEGR-Human N1796D SEQ ID NO: 80 <223> 23.M8H5GIEGR-Human T45K SEQ ID NO: 81 <223> 24.M8H5GIEGR-Human A135E SEQ ID NO: 82 <223> 25.M8H5GIEGR-Human V170S SEQ ID NO: 83 <223> 26.M8H5GIEGR-Human V148D SEQ ID NO: 84 <223> 27.M8H5GIEGR-Human G172Q SEQ ID NO: 85 <223> 33.M8H4DK-Human M41K + R66H SEQ ID NO: 86 <223> 34.M8H4DK-Human M41K + N1796D SEQ ID NO: 87 <223> 35.M8H4DK-Human R66H + N1796D SEQ ID NO: 88 <223> 36.M8H4DK-Human M41K + R66H + N1796D SEQ ID NO: 89 <223> 37.M8H4DK-Human M41K SEQ ID NO: 90 <223> 38.M8H4DK-Human R66H SEQ ID NO: 91 <223> 39.M8H4DK-Human N1796D SEQ ID NO: 92 <223> 40.M8H-Human wt SEQ ID NO: 93 <223> 41.M8H-Human R66H + N1796D SEQ ID NO: 94 <223> 42.untagged-Human R66H + N1796D SEQ ID NO: 95 <223> 61.untagged-Human wt

Abbreviations

A1M: alpha-1-microglobulin, IB: inclusion bodies, wt: wildtype, R66H: point mutation in A1M-gene leading to expression of His instead of Arg at position 66, N17,96D: point mutations in A1M-gene leading to expression of Asp instead of Asn at positions 17 and 96, M8H4DK: peptide with amino acid sequence MHHHHHHHHDDDDK (SEQ ID NO: 97), M6H4DK: peptide with amino acid sequence MHHHHHHDDDDK (SEQ ID NO: 98), M8H: peptide with amino acid sequence MHHHHHHHH (SEQ ID NO: 99), M8H5GIEGR: peptide with amino acid sequence MHHHHHHHHGGGGGIEGR (SEQ ID NO: 96), CV: column volume, SEC: size-exclusion chromatography, DLS: dynamic light scattering, DSF: differential scanning fluorimetry, Gu-HCl: guaninidine hydrochloride, ORAC: oxygen radical antioxidant capacity, SD: standard deviation, PAGE: polyacrylamide gel electrophoresis.

Definitions

In describing and claiming the disclosed subject matter, the following terminology will be used in accordance with the definitions set forth below. Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this disclosure belongs. In some cases, terms with commonly understood meanings are defined herein for clarity and/or for ready reference, and the inclusion of such definitions herein should not necessarily be construed to represent a substantial difference over what is generally understood in the art. The techniques and procedures described or referenced herein are generally well understood and commonly employed using conventional methodology by those skilled in the art. As appropriate, procedures involving the use of commercially available kits and reagents are generally carried out in accordance with manufacturer defined protocols and/or parameters unless otherwise noted. Although any methods and materials similar or equivalent to those described herein can also be used in the practice or testing of the present disclosure, the preferred methods and materials are described herein.

In this specification, unless otherwise specified, “a” or “an” means “one or more”.

The terms “treatment or prophylaxis” in their various grammatical forms in relation to the present invention refer to preventing, curing, reversing, attenuating, alleviating, ameliorating, inhibiting, minimizing, suppressing, or halting (1) the deleterious effects of a disorder, (2) disorder progression, or (3) disorder causative agent.

The term “effective amount” in relation to the present invention refers to that amount which provides a therapeutic effect for a given condition and administration regimen. This is a predetermined quantity of active material calculated to produce a desired therapeutic effect in association with the required additives and diluents; i.e., a carrier, or administration vehicle. Further, it is intended to mean an amount sufficient to reduce and most preferably prevent a clinically significant deficit in the activity and response of the host. Alternatively, a therapeutically effective amount is sufficient to cause an improvement in a clinically significant condition in a host. As is appreciated by those skilled in the art, the amount of a compound may vary depending on its specific activity. Suitable dosage amounts may contain a predetermined quantity of active composition calculated to produce the desired therapeutic effect in association with the required diluents; i.e., carrier, or additive. Further, the dosage to be administered will vary depending on the active principle or principles to be used, the age, weight etc. of the patient to be treated but will generally be within the range from 0.001 to 1000 mg/kg body weight/day. Moreover, the dose depends on the administration route.

The term “polypeptides” includes proteins and fragments thereof. Polypeptides are disclosed herein as amino acid residue sequences. Those sequences are written left to right in the direction from the amino to the carboxy terminus. In accordance with standard nomenclature, amino acid residue sequences are denominated by either a three letter or a single letter code as indicated as follows: Alanine (Ala, A), Arginine (Arg, R), Asparagine (Asn, N), Aspartic Acid (Asp, D), Cysteine (Cys, C), Glutamine (Gln, Q), Glutamic Acid (Glu, E), Glycine (Gly, G), Histidine (His, H), Isoleucine (Ile, I), Leucine (Leu, L), Lysine (Lys, K), Methionine (Met, M)₁ Phenylalanine (Phe, F), Proline (Pro, P), Serine (Ser, S), Threonine (Thr, T), Tryptophan (Trp, W), Tyrosine (Tyr, Y), and Valine (Val, V).

“Variant” refers to a polypeptide or polynucleotide that differs from a reference polypeptide or polynucleotide, but retains essential properties. A typical variant of a polypeptide differs in amino acid sequence from another, reference polypeptide. Generally, differences are limited so that the sequences of the reference polypeptide and the variant are closely similar overall (homologous) and, in many regions, identical. A variant and reference polypeptide may differ in amino acid sequence by one or more modifications (e.g., substitutions, additions, and/or deletions). A substituted or inserted amino acid residue may or may not be one encoded by the genetic code. A variant of a polypeptide may be naturally occurring such as an allelic variant, or it may be a variant that is not known to occur naturally.

The invention is further illustrated in—but not limited to—the figures.

LEGEND TO FIGURES

FIG. 1. Amino acid sequence alignment of A1M from 12 different species.

The amino acid sequence of human wt A1M and 11 additional species (SEQ ID NOS 1 and 104-114, respectively, in order of appearance) investigated in project phase I were aligned using the http://www.ebi.ac.uk/Tools/msa/clustalw2/software. The identity of the different sequences to the human sequence is presented as percent. Amino acids identical between all species in the set are marked with yellow. Additionally, amino acids believed to be important in human A1M are marked: the unpaired cysteine residue (C34) important for reduction and antioxidant properties (Allhorn et al., 2005) as well as heme binding is marked with pink (Mening and Skerra, 2012). The asparagines known to be glycosylated (N17 and 96) are marked with green (Escribano et al, 1990). The four lysines (K69, 92, 118 and 130) that have been found modified in urine A1M (Åkerström et al., 1995; Berggård et al., 1999) and are believed to be important for the reductase activity (Allhorn et al., 2005) are marked with light blue. The H123 suggested to take part in the heme-binding (Meining and Skerra, 2012) is marked with grey and finally the tyrosines (Y22 and 132) shown to be involved in radical scavenging (Åkerström et al., 2007) are marked in dark blue.

FIG. 2. SDS-PAGE of expressed proteins in phase III.

Equal amount of bacterial lysate from uninduced samples (marked 0) and samples taken one to four hours after induction (marked 1, 2, 3, 4) were separated by SDS-PAGE. In these samples a band slightly below 25 kDa is expressed at increasing amounts by time. The intensity of the bands culminates after 3 hours of induction. M8H-tagged wt-A1M and R66K+N17,96D-A1M are expressed with molecular weights slightly smaller than for the M8H4DK bands, but also here the expression level culminates around 3 hours. Untagged wt-A1M and R66H+N17,96D-A1M appear as even smaller bands, but here the intensity of the bands is stronger at 4 hours than 3 hours indicating a slightly delayed expression, in particular for wt A1M.

FIG. 3. Yield, purity and aggregation of phase III variants.

A. The yields of purified A1M of all phase Ill variants were compared. All variants resulted in good yields, with a slightly lower yield of the untagged wt-A1M. B. The purity was investigated by separation of 10 μg of all variants on SDS-PAGE. The purity was determined by densiometric analysis of the main monomeric band compared to all bands using the Image software from Bio-Rad. All histidine-tagged variants showed very high purity while the purities of the untagged variants were a little bit lower (around 90%). C. The presence of large aggregates were analysed by separating 20 μg of each variant by native PAGE. The intensity of the main monomeric band and the material remaining in the application slit (very large aggregated) were determined by densiometry. Most variants showed low amounts of large aggregates with exception of M8H-wt-A1M and the untagged variants, which show a slightly higher percentage. All variants are coded by a number given in panel A.

FIG. 4. Aggregation analysis of 100 μM and 1 mM solutions of phase III variants in various buffers.

The tendency to aggregate after concentration from 100 μM to 1 mM in different buffers was investigated by native PAGE analysis. 20 μg of protein were separated in each lane. The percent large aggregates were calculated using densiometry analysis of the individual band intensities.

A. All variants were concentrated from 100 μM to 1 mM in Tris-buffer pH 8.0 or 7.4 and separated by PAGE. The M8H4DK-wt, R66H+N1796D, M41K, R66H, N1796D are labelled 60, 35, 37, 38 and 39 respectively, the M8H-wt and M8H-R66H+N1796D are labeled 40 and 41 and the untagged wt and R66H+N1796D are labelled 61 and 42.

B. The variants were concentrated to 1 mM in TRIS-buffer pH 8.0 and 7.4 and in PBS pH7.4, subjected to one freeze-thaw cycle, and then separated by PAGE and analysed as described.

FIG. 5. Analysis of reductase and antioxidant capacity of phase III variants.

A. The reductase activity was analysed as the reduction of the ABTS radical. 0-2 μM A1M were added in duplicates to 56 μM ABTS radical. The reduction was followed as decrease of absorbance at 405 nm during 95 seconds. The area under the curve (AUC) for each concentration was calculated and the Net AUC was calculated by subtracting the AUC of buffer only. The average Net AUC+/−SEM of the duplicates was plotted against concentration. All M8H4DK-variants have about the same activity as wt A1M with a tendency to lower activity for M41K and R66H. The M8H and untagged variants also show full activity with a small tendency of higher activity of the R66H+N1796D variants compared to wt A1M.

B. The antioxidation ability was investigated in the ORAC assay. The activities of the A1M-variants were compared to a Trolox standard and expressed as number of Trolox equivalents. Each assay was done in triplicates and the result of M84DK-wt was set to 100%. The antioxidation capacities of all other variants were expressed in relation. The M8H4DK-R66H+N17,96D variant showed significantly higher capacity than the M8H4DK-wt A1M. When the tags were shortened or removed the difference was smaller. Data presented are the combined results of two independent experiments.

FIG. 6. Analysis of reductase activity and heme binding of phase III variants.

A. The ability of A1M-variants to reduce cytochrome c was investigated by mixing dilution series (0-10 μM) of A1M with 100 μM cytochrome c+100 μM NADH and following the increase in absorbance at 550 nm for 20 minutes. The assay was done in duplicates. The AUC was calculated for each concentration and the Net AUC was calculated by subtraction of the AUC of buffer only. Data are presented as the Net AUC+/−SEM of two independent experiments. Ovalbumin was used as a negative control. Most A1M variants showed a slightly lower reduction capacity compared to wt at the lower concentrations. For N17,96D-A1M and R66H+N17,96D-A1M it is significant (at 0.3-0.6 μM). Shortening and removal of the tag had no influence of this property.

B. The incorporation of heme into the A1M-variants was analysed by the appearance of an absorbance peak between 410-420 nm, and the magnitude of the red-shift of the peak (Karnaukhova et al., 2014; Rutardottir et al., 2016). 44 μM protein solutions were mixed with 40 μM heme in duplicates and incubated for 2 hours at RT. The mixtures were analysed by wavelength scan between 270-450 nm. The position of the maximal peak and the 413:386 ratio were calculated. All M8H4DK-variants have about the same red-shift and ratio as wt-A1M, while the M8H-tagged variants have significantly higher ratio. The untagged variants lack red-shift activity, confirming previous results (Karnaukhova et al., 2014).

C. The binding of A1M to heme agarose. The specific binding of A1M was analysed by mixing dilution series of A1M, or the control ovalbumin, with heme-agarose or control agarose. The assay was made in duplicates. Protein quantification of the starting material and the flow-throughs from heme-agarose and control agarose incubations was determined using BCA. From these data the amount of protein specifically bound to heme agarose could be determined for each sample. Bound protein was plotted against added protein, and a linear correlation was seen for all variants. The slope of the line was calculated with linear regression and the average between the duplicates is shown. All variants bind heme in this method to about the same extent.

FIG. 7. Rescue of K562 cells from heme-induced cell death.

K562 cells were exposed to 100 μM heme in the presence of a dilution series of A1M (0-10 μM) for 1 hour. Then, cell death was monitored as release of LDH into the medium. The absorbance value from live cells was subtracted and the signal of heme-incubated cells without A1M was set to 100%. The values of the A1M incubations were calculated in relation to this. The assay was made in duplicates. The average result from three independent experiments (mean+/−SEM) is shown in the figure. No significant difference could be seen between any of the variants except for untagged R66H+N17,96D-A1M that has lower activity than untagged wt-A1M.

FIG. 8. Size-distribution and reductase activity of M8H4DK-R66H+N17,96D-A1M and M8H4DK-wt-A1M after storage at +4° C. and room-temperature.

M8H4DK-Wt-A1M and M8H4DK-R66H+N17,96D-A1M are depicted as “wt” and “variant 35” and shown in the upper and lower panels, respectively. Aggregation was analysed by SEC-FPLC. Monomeric A1M and large aggregates were eluted around 15 ml and 8 ml, respectively. The small shoulder seen around 13-14 ml most likely is dimeric A1M. The percentage of large aggregates was calculated from the area under the 8 ml peak compared to the total peak area. The recovery of protein (%; shown in italic) after stress exposure was calculated from the total peak areas compared to the total peak area of the starting material. The reduction activity of ABTS was analysed in 2 μM A1M solutions. Data are shown as average of duplicates. Freshly thawed 100 μM A1M solutions are shown in (A), 100 μM A1M exposed to five freeze-thaw cycles (B), 1 mM A1M stored at +4° C. over-night (C), 1 mM A1M stored at +4° C. for a week (D), 100 μM A1M stored at RT for a week (E), and 1 mM A1M stored at RT for a week (F). Data show that M8H4DK-R66H+N1796D better tolerates concentration to 1 mM (C & D) and storage at RT (E and F).

FIG. 9. Size-distribution and reductase activity of 1 mM M8H4DK-wt-A1M and M8H4DK-R66H+N17,96D-A1M after storage at +37° C.

Wt-A1M and R66H+N17,96D-A1M are depicted as “ht2014” and “35” and shown in the upper and lower panels, respectively. Aggregation was analysed by SEC-FPLC. Monomeric A1M and large aggregates are eluted around 20 min and 12 min, respectively. The small shoulder seen around 18-19 min most likely is dimeric A1M. The percentage of large aggregates was calculated from the area under the 12 min peak compared to the total peak area. The recovery of protein (%; shown in italic) after stress exposure was calculated from the total peak areas compared to the total peak area of the starting material. The reduction activity of ABTS was analysed in 2 μM A1M solutions. Data are shown as average of duplicates. 1 mM A1M solutions stored for 1.5 hours (B), 2.5 hours (C) and 4.5 hours (D) were compared to 1 mM A1M start material (A). The M8H4DK-wt at 4.5 hours was completely precipitated and could not be analysed. Data show that M8H4DH-R66H+N1796D better tolerates storage at +37° C. than M8H4DK-wt.

FIG. 10. Model of the structure of A1M. The model was prepared as described (ref 29). The eight β-strands, shown as ribbons, form a slightly cone-shaped cylinder with a hydrophobic interior: the “lipocalin pocket”. One side of the lipocalin pocket is open (shown by the arrow), i.e. it permits entrance of small molecules. The opposite side is closed. Two α-helices are shown as cylinders. The positions of three carbohydrate groups (T5; N17; N96) and four side-chains involved in reductase activity (C34; K92; K118; K130) are shown.

FIG. 11

Heme-binding analysed by migration shift/fluorescence quenching on native PAGE (A and B), and UV-absorbance spectrophotometry (C). A. Fifteen μg M8H4DK-wt A1M (wt-A1M) or M8H4DK-35-A1M (35-A1M) were incubated with different amounts of heme for 30 min at 20° C., separated by native PAGE, and the gel analysed by tryptophan fluorescence (Fluorescence) and densitometry scanning after Coommassie staining (Stain). B. The images were digitalized by using Image Lab™ Software (Bio-Rad). Heme binding, measured as fluorescence quenching (black) and migration distance (blue) were plotted against the molar ratio A1M:heme. Mean values of duplicate experiments are shown, wt-A1M (filled symbols), 35-A1M (open symbols). C. A1M and heme were mixed (32 and 19 μM, respectively), incubated for 2 h at 20° C. and scanned. The absorbance of the proteins alone at 32 μM are shown as comparison. The absorbance of the buffer (20 mM Tris-HCl, pH 8.0+0.15M NaCl) was subtracted from all scans as blank.

FIG. 12

Comparison of the enzymatic properties of M8H4DK-wt A1M (wt-A1M) and M8H4DK-35-A1M (35-A1M). A. Freshly purified wt-A1M (▪) or 35-A1M (∘) at various concentrations were mixed with ABTS-radical at 56 μM in 25 mM sodium phosphate buffer pH 8.0 in microtiter plate wells, and the rate of reduction was followed by reading the absorbance at 405 nm during 95 seconds. The absorbance for each concentration was plotted against time and the area under the curve (AUC) between 0 and 95 s was calculated for each concentration. The net AUC was calculated by subtracting the AUC of buffer only. Mean of triplicates+/−SEM are shown. B. The ABTS-reduction rate was determined as described in A, but using wt-A1M (▪) or 35-A1M (∘) after storage for 7 days at 4° C. or room-temperature and 0.1 or 1 mM. Single experiments are shown. C. The reduction of cytochrome c was investigated by mixing dilution series (0-10 μM) of wt-A1M (▪) or 35-A1M (∘) with 1001M cytochrome c+100 μM NADH and following the increase in absorbance at 550 nm for 20 minutes. The assay was done in duplicates. The AUC was calculated for each concentration and the Net AUC was calculated by subtraction of the AUC of buffer only. Data are presented as the Net AUC+/−SEM of two independent experiments. Ovalbumin was used as a negative control. D. The antioxidation ability was investigated in the ORAC assay. The activities of the A1M-variants at 5 μM were compared to a Trolox standard and expressed as number of Trolox equivalents. Each assay was done in triplicates and the result of wt-A1M was set to 100%. Data presented are the mean of two independent experiments+/−SEM.

FIG. 13

K562 cells cultured at 10⁵ cells per well in a 96-well microtiter plate, were exposed to 100 μM heme in the presence of a dilution series of M8H4DK-wt A1M (wt-A1M) or M8H4DK-35-A1M (35-A1M) (0-10 μM) for 1 hour. Cell death was monitored as release of LDH into the medium. The LDH-value from live cells was subtracted and the signal of heme-incubated cells without A1M was set to 100% and the values of the A1M incubations were calculated in relation to this. The assay was made in duplicates. The average result from three independent experiments (mean+/−SEM) is shown. Wt-A1M (▪) or 35-A1M (∘).

FIG. 14

HK-2 cells were exposed to a mixture of 200 μM (NH₄)Fe(SO₄)₂, 400 μM hydrogen peroxide, and 2 mM ascorbate (the Fenton reaction, displayed in A and B) or 0-30 μM heme (displayed in C and D) with or without the simultaneous addition of 0-20 μM M8H4DK-wt A1M (wt-A1M) (displayed as ▪ and black columns) or M8H4DK-35-A1M (35-A1M) (displayed as ø and white columns) for 6 hours. After incubation, cells were analyzed for cell viability using WST-1 (displayed in A and C) or mRNA expression of HO-1 and Hsp70 (displayed in B and D) as described in materials and methods. The cell viability (A and C) was normalized against control samples from untreated cells. Results are from triplicate experiments and presented as mean±SEM. The mRNA expression of HO-1 and Hsp70 (B and D) was normalized against GAPDH and is given as fold change. The fold-change values were calculated by normalizing against control samples from untreated cells. Results are from triplicate experiments and presented as mean±SEM. Differences between the respective exposures and control conditions were analyzed using One way ANOVA with post hoc Bonferroni correction. * indicates statistical comparison vs. Fenton (displayed in B) or heme (displayed in D). *P<0.05, **P<0.01, ***P<0.001. No significant difference was observed when comparing wt-A1M vs. 35-A1M.

FIG. 15

Plasma clearance (pharmacokinetics, displayed in A) and biodistribution (displayed in B) of M8H4DK-wt A1M (wt-A1M) and M8H4DK-35-A1M (35-A1M) injected intravenously in animals. A. Wt-A1M (●) or 35-A1M (∘) was injected (5 mg/kg) in Wistar rats and blood was collected at regular intervals. A1M-concentrations were determined by RIA using the particular A1M-variant as standard. Each point are from three animals and presented as mean±SEM. B. Wt- or 35-A1M, 5 mg/kg, was injected intravenously in C57BL/6NRj-mice which were sacrificed 10 and 30 min post-injection. Organs were sampled, weighed and homogenized. Concentrations of injected (human) A1M were determined by sandwich-ELISA. Each bar are from three animals and presented as mean±SD. Wt-A1M, 10 min (black) and 30 min (dark gray); 35-A1M, 10 min (white) and 30 min (light gray).

FIG. 16

Female C57BL/6 mice were exposed to Glycerol (2.0 ml/kg, i.m.) followed by i.v. administration of either M8H4DK-wt A1M (wt-A1M) (dark grey bars, n=10), M8H4DK-35-A1M (35-A1M) (white bars, n=10) or vehicle buffer (sham control, grey bars, n=6) 30 minutes post-glycerol injections. At 4 hours (post-glycerol administration) animals were euthanized and kidneys excised, snap frozen and subsequently analyzed for mRNA expression of HO-1 (A) and Hsp70 (B) using real-time PCR as described in materials and methods. mRNA expression were normalized against those of GAPDH and fold change values were calculated by normalizing against control samples from untreated animals (controls). Results are presented as box plots, displaying medians and 25^(th) and 75^(th) percentiles. Statistical comparison between groups were performed by ANOVA with post hoc Bonferroni correction. * indicates statistical comparison vs. Glycerol. *P<0.05, **P<0.01. No significant difference was observed when comparing wt-A1M vs. 35-A1M.

The invention is further illustrated in the following examples. The examples are illustrative and do not limit the scope of the invention in any manner.

EXPERIMENTAL

The experimental work was divided into three major phases:

Phase I) Expression of the 27 A1M-variants described above followed by analysis of solubility, stability and function;

Phase II) Design, expression and analysis of a few A1M-variants with expected optimal properties based on the outcome of phase 1;

Phase III) Design, expression and analysis of wt-A1M and the most successful mutated A1M-variant equipped with or without N-terminal tags.

In Phase I, four lines of reasoning were used, when selecting the positions and identities of mutated amino acid side-groups: 1) Animal homologues from a variety of species with different expected environmental pressure in terms of oxidative stress, temperature, oxygen pressure were expressed (N=12); 2) Single amino acid substitutions that occur frequently among the 56 sequenced A1M-homologues at positions located in loops 1-4 or the interior surface of the hydrophobic pocket, were introduced into the human gene construct and expressed (N=3); 3) Addition or removal of favourably located lysyl or tyrosyl residues, based on the hypothesis that these may infuence pKa of the C35 thiolyl (Allhorn et al., 2005) or serve as radical-trapping sites (Berggård et al., 1999; Sala et al., 2004; Åkerström et al. 2007) (N=5); 4) Hydrophobic-hydrophilic substitutions on the surface of the protein, with no predicted influence on function or folding (N=7).

Materials and Methods

Expression

The sequences of the A1M variants were provided to DNA2.0, Inc. (USA) which synthesized the genes and cloned them into their PJ401 Express vector (T5 promoter, kanamycin resistance). The DNA sequence was confirmed by sequencing. The vectors were transformed into competent E. coli (BL21 Star(DE3) (Invitrogen, Life technologies corp, USA)) according to the manufacturer's instructions and four individual clones of each variants were tested for micro-expression. The clone with highest expression of each variant was prepared as a glycerol stock which was used for production expression.

A1M variant expression clones were grown in complete NYAT (15 mM (NH₄)₂SO₄, 84 mM K₂HPO₄, 23 mM NaH₂PO₄×H₂O, 2.2 mM (NH₄)₂Hcitrate, 1% (w/v) glucose, 2 mM MgSO₄, 91M CaCl₂×2H₂O, 85 μM FeCl₃×6 H₂O, 1.3 μM ZnSO₄×7 H₂O, 1.3 μM CuSO₄×5 H2O, 1.8 μM MnSO₄×H2O, 1.5 μM CoCl₂×6 H₂O, 108 μM EDTA, 50 μg/ml kanamycin) to an OD₆₀₀ of 1.5. Then protein expression was induced by addition of 1 mM IPTG. The production went on for 4 hours. Samples for SDS-PAGE analysis were taken before induction, and 1, 2, 3 and 4 hours after induction.

Purification

Bacteria from the cultures were collected by centrifugation at 5000 rpm, 15 minutes. The bacterial pellets were lysed by five freeze-thaw cycles, diluted 3 times in 20 mM Tris-HCl pH 8.0 and sonicated. The inclusion bodies (IB's) were collected by centrifugation at 6000 rpm, 30 minutes, and washed by three more cycles of resuspension and centrifugation. For extraction, the IB's were resuspended in 6M guanidine-hydrochloride, 20 mM Tris-HCl pH 8.0 (6M Gu-HCl) and incubated with stirring overnight at +4° C. The extract was clarified by high-speed centrifugation at 26000 g, 60 minutes. The supernatant was saved for further clarification, while the pellet went through another cycle of extraction. The supernatants of the extractions were combined and further clarified by depth filter filtration (K700P filter laid on top of KS50P filter, Pall Corp., USA). A1M in the clarified extract was purified, using a Ni-agarose resin (Sigma-Aldrich, USA). Briefly, the resin was packed into a 10-ml disposable chromatography column (Bio-Rad, USA) and equilibrated in 6M Gu-HCl. The A1M extract was applied onto the column using free-flow and the flow-through collected. The column was washed with five column volumes of 6M Gu-HCl and then eluted with four volumes of 6M Gu-HCl+0.5 M imidazole. Starting material, flow-through and eluted fractions were precipitated with ethanol, resolved in 1×SDS-PAGE loading buffer and separated by SDS-PAGE. The purification procedure was repeated if the flow through contained significant amounts of A1M. The protein content of the extract was determined by absorbance 280 nm.

The Ni-agarose eluates were diluted to an approximate A₂₈₀ of 5.0 and cooled to +4° C. before refolding. The eluate was then mixed with ⅔ volumes of 0.275 M L-cystein in 20 mM Tris-HCl pH 9.5+0.1M NaCl. Then 16.7 volumes refolding buffer were quickly added. The final buffer concentration was: (0.2 mg/ml A1M, 0.1M Tris, 0.6 M NaCl, 0.45 M L-arginine, 2 mM EDTA, 10 mM L-cystein and 1 mM L-cystein, pH 9.5). The mixture was then stirred for 1 hour at +4° C., and the solution concentrated to the initial volume of the A1M solution using Centricon plus 70, 10K ultrafiltration devices (Merck Millipore; USA). After concentration, the A1M solution was diafiltrated to 20 mM Tris-HCl pH 8.0 using the same devices, by 10 consecutive 2.5× dilution/concentration cycles. After diafiltration the solution was clarified by centrifugation at 15000 g for 15 minutes and then run through a 0.2 μm filter.

The refolded A1M was immediately applied to a 5 ml Bio-Scale Mini UNOsphere Q Cartridge (Bio-Rad), equilibrated with 20 mM Tris-HCl pH 8.0. The column was run on an ÄKTA purifier 10 instrument (GE Healthcare, USA) according to Bio-Rad's instruction for the cartridges. After sample application the column was washed with five column volumes (CV) of 20 mM Tris-HCl pH 8.0 before elution with a 20 CV linear gradient from 0-0.35M NaCl. Finally, the column was washed with three CVs of 1 M NaCl. The flow-through and selected fractions collected during the linear gradient were analysed by SDS-PAGE. Flow-through with remaining A1M was immediately re-run on a new column and the A1M containing fractions were pooled, concentrated to 1001M, sterile filtered and frozen at −20° C. in aliquots.

Gel Electrophoresis

SDS-PAGE was run according to Laemmli (Laemmli, 1970) using standard protocols. Proteins were separated on stain-free 4-20% TGX gels (Bio-Rad) at 300V for 17 minutes. Native PAGE was run without SDS and without reducing agents on stain-free 4-20% TGX gels at 200V for 40 minutes. The gels were analysed on a Chemidoc MP instrument (Bio-Rad).

Circular Dichroism

The circular dichroism spectra were recorded on a Jasco-J180 spectrofluorimeter instrument (JASCO Inc., Japan) of 10 μM solutions in 20 mM Tris-HCl pH 8.0+0.15 M NaCl in a 2-mm cuvette. The solutions were scanned at +22° C. between 190-260 nm. Three runs were overlayed for each sample. The percentage of α-helix and β-sheet structure was calculated using the http://k2d3.ogic.ca software.

SEC-FPLC

Proteins were analysed by size exclusion on an ÄKTA purifier 10 instrument using a 24-ml Superose 12 10/30 GL column (GE Healthcare). The column was equilibrated with 20 mM Tris-HCl pH 8.0+0.15 M NaCl using a flow-rate of 1 ml/min. 100-200 μg of protein were loaded onto the column in a volume of 100 μl and eluted with 20 mM Tris-HCl pH 8.0+0.15 M NaCl using a flow-rate of 0.75 ml/min. Typically, monomeric A1M was eluted after 15 ml/20 min, dimeric after 13-14 ml/18-19 min, and large aggregates were eluted after 8 ml/12 min. The percentage of large aggregates was calculated from the area under the 8-ml peak compared to the total peak area. The percentage of total protein retrieved on the column after stress treatments (see below) was calculated by comparing the total peak areas of treated vs. non-treated samples.

RP-HPLC

Reversed phase HPLC was run on an Agilent 1260 Infinity Binary LC system using an Aeris Wildpore 3.6 μM XP-C8 column (Phenomenex Inc., USA). The column was run at +25° C. using a flow rate of 1 ml/min and equilibrated with a mixture of 70% H₂O+0.1% TFA and 30% Acetonitrile+0.1% TFA. 10 μl (=10 μg of protein) were loaded and eluted with a linear gradient of 30-50% acetonitrile over 20 minutes. The column was regenerated by washing with 95% acetonitrile for 10 minutes.

Dynamic Light Scattering

Dynamic light scattering (DLS) analysis of non-stressed and shearing-stressed samples was done using the service of SARomics Biostructure AB, Lund. A1M samples, diluted to 10M in 10 mM Tris-HCl pH 8.0+0.125 M NaCl, were analysed on a Malvern APS instrument at +20° C. Samples were prepared in duplicates and each sample was monitored three times.

Differential Scanning Fluorimetry

Thermostability of the A1M variants was analysed by differential scanning fluorimetry (DSF) using the service of SARomics Biostructure AB, Lund. A1M diluted to 4.4 μM in 10 mM HEPES pH 8.0+0.125 M NaCl was mixed with SYPRO orange (1000× dilution of SYPRO orange in total). The analysis was made in duplicates and the average melting temperature (Tm) was calculated.

Introduction of Stress by Shearing Forces

10 μl of 100-μM A1M solutions were exposed to shearing force stress by 80 pipettings with a multiple channel pipett using 0-10 μl pipett tips. The stress-treatment was performed in duplicates. After pipetting, the duplicates were combined and diluted 10 times before analysis with DLS as described.

High Concentration-Induced Stress

Solubility and stability of A1M was analysed at high concentration. 500 μl of 100 μM A1M solutions were concentrated tenfold to 50 μl using Amicon Ultra-0.5, 10K devices (Merck Millipore) by centrifugation at 14000 g for 10 min. After concentration the volumes were corrected to exactly 50 μl using the respective flowthroughs. Concentrated and non-concentrated samples (10 μg) were compared side-by-side on native PAGE. The influence of different buffers were examined by diafiltration of the samples before concentration. This was done by five cycles 10-time dilution/concentration in Amicon Ultra-15, 10K devices.

Quantification of Free Thiol Groups

The free thiol groups of the A1M variants were determined with the “Thiol and sulfide quantification kit” from Molecular probes. The assay was performed in 96-well plates according to the kit manual. A volume of 3 μl standard or A1M (100 μM) was mixed with 3 μl cystamine work solution, 100 μl papain-SSCH, 100 μL-BAPNA. The assay was read as absorbance 405 nm.

ABTS Reduction Assay

The assay is a modification of (Åkerström et al 2007). 7 mM of 2,2 Azino-bis (3-etylbenzothiazoline-6-sulfonic acid) di-ammonium salt (Sigma-Aldrich) was oxidized with 2.45 mM K₂S₂O₈ overnight, and then diluted to 56 μM in 25 mM sodium phosphate buffer pH 8.0. 100 μl of the ABTS working solution was added per well in a 96-well plate. A time-point zero measurement was done at A₄₀₅ using a Perkin Elmer Plate reader. 2 μl of an A1M solution (0-100 μM) were quickly added by a multiple channel pipett. The kinetics of the decrease in absorbance at 405 nm was quickly followed for 95 s. For practical reasons only 8 wells were analysed at the time. The A1M dilution series was run in duplicate or triplicates. If the number of samples to be analysed required several plates, new ABTS stock was diluted into working stock for each plate and an wt-A1M reference sample was included in all plates. The absorbance for each concentration was plotted against time and the area under the curve (AUC) was calculated for each concentration. The net AUC was calculated by subtracting the AUC of buffer only.

Oxygen Radical Antioxidant Capacity (ORAC) Assay

The commercial kit OxySelect™ Oxygen radical antioxidant capacity (ORAC) activity assay (Cell Biolabs, Inc. USA) is based on the oxidation and destruction of a fluorescent probe by peroxyl radicals. When an antioxidant is present this destruction is inhibited. As standard the water soluble vitamin E derivate, Trolox is used. Performance, analysis and calculations followed the kit manual and an A1M concentrations of 2.5-5 μM fitted nicely in to the standard curve. Ovalbumin (Sigma-Aldrich) was used as a negative protein control.

Cytochrome c Reduction Assay

The assay is modified from (Allhorn et al. 2005). A working solution was made by mixing 100 μM cytochrome c (Sigma-Aldrich) and 1001M NADH in 10 mM Tris-HCl pH 8.0+0.125M NaCl. 11 μl of an A1M solution (0-100 μM) were added to a 96-well plate in duplicates. 100 μl of the cytochrome c working solution was quickly added per well using a multichannel pipett. The kinetics of the increase in absorbance at 550 nm was followed for 20 minutes. One plate was analysed at the time. No biases over time could be observed. If several plates were to be analysed the same working solution was used for all without any observable artefacts caused by this procedure. After measurements the results were analysed as described for the ABTS assay.

The Red-Shift Assay

The incorporation of free heme in A1M yields a red-shift of the Soret band absorbance peak (Karnaukhova et al., 2014; Rutardottir et al., 2016), and was evaluated in the A1M-mutants as the A₄₁₃/A₃₈₆ ratio. 44 μM A1M in 20 mM Tris-HCl pH 8.0+0.25M NaCl was mixed with 40 μM free heme (Applichem). The incubations were done in duplicates and incubated for 2 hours at room temperature. The red-shift was analysed in four times diluted samples by wavelength scan in a Beckman Spectrophotometer. The average maximal peak of the duplicates as well as the average ratio between the absorbances at 413 and 386 nm was calculated. Ovalbumin and buffer only were used as negative controls.

Specific Binding of a 1M to Heme-Agarose

Binding of A1M to heme-agarose was analysed by the method of (Larsson et al., 2004), modified as described (Rutardottir et al., 2016). Heme-agarose (Sigma-Aldrich) and control Sepharose 4B (Sigma-Aldrich) were equilibrated with 20 mM Tris-HCl pH 8.0+0.25M NaCl and prepared as 50% slurries. 75 μl of an A1M dilution series (0-13.3 μM) were added to duplicate 96-well plates (one plate for heme agarose and one for control Sepharose). 20 μl of heme-agarose och control Sepharose slurry were added to the wells by careful pipetting to assure transfer of similar amounts, and incubated for 30 minutes at RT during rotational stirring. The mixtures were carefully transferred to an AcroPrep Advance 96-well filter plate, 1.2 μm Supor membrane (Pall Corp). The plates were centrifuged for 2 min at 1000 g collecting the flow-through in a low-binding microplate. 25 μl of each flow-through, as well as the non-incubated starting material, were assayed for protein content using Pierce BCA Protein Assay kit (Thermo Scientific Inc., USA). Protein amounts were recalculated as amount bound (added minus amount in flow-through) for both the heme- and control Sepharose-incubated samples.

After subtraction of the amount bound to the control Sepharose, the amount specifically bound to heme agarose was plotted against the added amount. The slope of the curve was calculated with linear regression. The SD of the duplicates were used to evaluate the significance of the differences between the A1M variants.

Heme Binding of M8H4DK-Wt a 1M (Wt-A1M) and M8H4DK-35-A1M (35-A1M)

Heme binding was analysed as previously described by native PAGE (Karnaukhova et al., 2014) and UV-spectrophotometry (Ruttarsdottir et al., 2016). Briefly, for native PAGE, A1M and various concentrations of heme were incubated in Tris-buffer, pH 8.0 for 30 min at room temperature, separated by native PAGE on stain-free 12% Criterion TGX gels at 200V for 40 minutes. The gel bands were analysed on a Chemidoc MP instrument (Bio-Rad) for tryptophan fluorescence using the Stain-free setting, stained with Coommassie Brilliant Blue, destained and imaged again on the Chemidoc using the Coommassie setting. Both sets of bands were then quantified using Image Lab™ Software (Bio-Rad). Heme binding was then estimated as the amount of quenching of the tryptophan fluorescence relative to total protein amounts after Coommassie staining. Absorbance spectra were measured on a Beckman (Beckman Instruments, Fullerton, Calif.) DU 800 spectrophotometer using a scan rate of 600 nm/min in the UV-VIS region between 250 and 700 nm at 22° C. Concentrations of A1M and heme were 32 and 19 μM, respectively, in 20 mM Tris-HCl, pH 8.0, 0.15 M NaCl. Heme was added from a stock solution of 10 mM in DMSO. Protein solutions were scanned 2 h after mixing.

Plasma Clearance and Biodistribution

For the plasma clearance studies, each A1M-variant was injected intravenously (i.v) in six male Wistar rats (5.0 mg/kg; stock-solutions in 20 mM Tris-HCl, pH 8.0) and blood samples were taken in EDTA-tubes at 1, 5, 15, 30 min, and 1, 3, 6, 16 and 24 h post-injection, using different sampling intervals in groups of three rats to avoid over-sampling. Plasma was aspirated after centrifugation 140×g for 10 min, and the concentration of A1M was determined by radioimmunoassay (RIA) as described (Gram et al. 2015) using the specific A1M-variant as standard. For the biodistribution studies, the A1M-variants were injected i.v. in C57BL/6NRj mice (5.0 mg/kg; stock-solutions in 20 mM Tris-HCl, pH 8.0). The mice were sacrificed 10 min post-injection (n=3), and after 30 min (n=3). Organs were sampled, weighed and homogenized in 5:1 (vol:weight) Cell Extraction Buffer (Invitrogen, cat. No. FNN0011), containing 50 μl/ml cOmplete Mini, EDTA-free proteinase inhibitor cocktail tablets (Roche, cat. no. 11836170001). A1M-concentrations were determined by an in-house sandwich ELISA. Briefly, 96-well microtiter plates were coated overnight at 4° C. with mouse monoclonal anti-A1M (clone 35.14, 5 μg/ml in PBS), washed, and then incubated with A1M-standards (human urinary A1M, purified as described at our laboratory (Åkerström et al., 1995) or homogenised tissue samples, diluted in incubation buffer (PBS+0.05% Tween 20+0.5% bovine serum albumin), for 60 min at RT. After washing, the wells were incubated with horseradish peroxidase-conjugated mouse monoclonal anti-A1M (clone 57.10, 5 ng/ml in incubation buffer) for 60 min at RT. The plates were washed and developed by incubating with SureBlue TMB Microwell Peroxidase Substrate (KPL) in the dark for 20 min, and finally stopped with 1M sulfuric acid. Absorbance was read at 450 nm in a Wallac 1420 Multilabel Counter. The two mouse monoclonal antibodies were raised by AgriSera AB (Vännäs, Sweden) against human urinary A1M. The ELISA was specific for human A1M, did not cross-react with endogenous mouse plasma A1M, and reacted with human urinary A1M, M8H4DK-wt A1M (wt-A1M) and M8H4DK-35-A1M (35-A1M) equally well.

Rhabdomyolysis Induced Kidney Damage

This study was approved by the ethical committee for animal studies in Malmö-Lund, no. M21-15. Female C57BL/6 mice with a body weight of 20.5±0.7 g were obtained from Taconic (Denmark), housed in Type III cages with wire lids, at a constant room temperature with 12 hour light dark cycles. Temperature (20±0.5° C.) and relative moist (50±5%) was maintained throughout the studies. All animals had free access to food (RM1(E) SQC, SDS, England), tap water and cage enrichment. After overnight water deprivation (15 hours) animals were weighed and anaesthetized using isoflurane and then allocated to the following four groups: 1) Control (n=6), received no intramuscular (i.m.) or intravenous (i.v.) administration; 2) Glycerol (n=10), received 50% sterile glycerol (Teknova, Hollister, Calif., USA) i.m. (2.0 ml/kg body weight, single dose, divided into both hind limbs); 3) Glycerol+M8H4DK-wt A1M (wt-A1M) (n=10), received wt-A1M i.v. (7 mg/kg body weight, single dose) 30 minutes after glycerol i.m. (2.0 ml/kg body weight) administration; and 4) Glycerol+M8H4DK-35-A1M (35-A1M) (n=10), received 35-A1M i.v. (7 mg/kg body weight, single dose) 30 minutes after glycerol i.m. (2.0 ml/kg body weight) administration. Following i.m. administration animals were placed on a heat pad during awakening and then put back to their cages and supplied with free access to food and water. After 4 hours (post-glycerol injection) animals were anaesthetized using isoflurane and kidney collected for RNA extraction followed by mRNA evaluation as described below.

RNA Isolation and Real-Time PCR

Total RNA was isolated from HK-2 cells, using Direct-zol™ RNA MiniPrep supplied by Zymo Research (Irvine, Calif., USA), or mouse kidneys, using NucleoSpin RNA/Protein (Machery-Nagel, Duren, Germany) followed by RNeasy® Mini Kit (QIAGEN, Germantown, Md., USA). The OD ratio (optical density at 260 nm/280 nm) of RNA was always higher than 1.9. Reverse transcription was performed according to the manufacturer on 1.0 μg total RNA using iScript™ cDNA Synthesis Kit (Bio-Rad, CA, USA). RT² qPCR Primer Assay (human (HK-2 cells) and mouse (kidneys) primers from QIAGEN) were used to quantify the mRNA expression of heme oxygenase 1 (HO-1) and heat shock protein 70 (Hsp70). Data were normalized to glyceraldehyde-3-phosphate dehydrogenase (human (HK-2 cells) and mouse (kidney) GAPDH, RT² qPCR Primer Assay from QIAGEN). Data are presented as columns, displaying mean±SEM, for in vitro data and box plots, displaying medians and 25^(th) and 75^(th) percentiles, for in vivo data. The fold change values were calculated by normalizing against control samples from untreated cells or animals (controls). Expression was analyzed using iTaq™ Universal SYBR® Green Supermix (Bio-Rad). Amplification was performed as described by the manufacturer (Bio-Rad) for 40 cycles in an iCycler Thermal Cycler (Bio-Rad) and data analyzed using iCycler iQ Optical System Software (Bio-Rad).

Rescue of K562 Cells from Heme Induced Cell Death

A1M was previously shown to inhibit heme-induced cell-death of human erythroid K562 cells (Olsson et al., 2008). The cells were cultured in DMEM with glutamax+10% FCS and antibiotics (Gibco, Life Technologies Corp., USA) according to the instructions at ATCC. Cells were washed and resuspended in DMEM without phenol red and FCS but supplemented with glutamax I and antibiotics (Gibco). Cells were seeded into 96-well plates, 10⁵ cells per well, and exposed to 100 μM heme in the presence of a 0-10 μM A1M dilution series. As a positive control for cell death, 10 μl of lysis solution from the LDH detection kit (see below) was added. The cells were incubated in a 37° C. CO₂-incubator for 1 hour. The plates were quickly centrifuged at 350 g for 4 minutes before 50 μl of the medium was transferred to a 96-well microplate for analysis of LDH release using the cytoTox 96® Non-Radio. Cytotoxicity Assay (Promega Biotech AB, Sweden) according to the manufacturer's instructions. Heme-induced cells typically gave 7 times higher signal compared to live cells and 70% of the signal of completely lysed cells. The average signal of cells incubated without heme- or A1M-addition was subtracted from all and the signal of heme only-incubated cells was set to 100%. All other signals were related to this value. This procedure enabled comparison of several independent experiments.

Protection of HK-2 Cells

Human kidney cortex proximal tubule epithelial cells (HK-2, ATCC® CRL-2190, ATCC, Teddington, UK) were cultured in keratinocyte serum free medium (K-SFM) supplemented with bovine pituitary extract (BPE, 0.05 mg/ml) and epidermal growth factor (5 ng/mL)(all from Invitrogen, Paisley, UK). When cells reached approximately 80-90% confluence, heme (0-30 μM, from a freshly prepared 10 mM stock solution) or a mixture of (NH₄)Fe(SO₄)₂, hydrogen peroxide, and ascorbate (0-200 μM, the Fenton reaction), with or without the simultaneous addition of A1M (0-20 μM, M8H4DK-wt A1M (wt-A1M) and M8H4DK-35-A1M (35-A1M)), were added and cells were incubated for 6 hours. After incubation, cells were analyzed for cell viability using WST-1 (the measured metabolic activity of cells, e.g. measurement of cellular cleavage of the WST-1 stable tetrazolium salt to the soluble formazan dye, is a direct correlate to the number of viable cells)(Roche Diagnostics GmbH, Mannheim, Germany) according to the instructions from the manufacturer. The cell viability was normalized against control samples from untreated cells. Parallel cultures were harvested using Qiazol™ Lysis reagent (for RNA extraction, QIAGEN, Germantown, Md., USA). Total RNA was extracted from cells to evaluate mRNA expression as described below.

Statistics

Comparisons between unrelated groups were performed by ANOVA with post hoc Bonferroni correction. P-values <0.05 were considered significant.

Results and Discussion

Project Overview

The purpose of this investigation is to identify more stable and soluble variants of A1M with preserved functional properties. The project was performed in three phases. In phase I, A1M of different species and point mutations of human A1M were screened to identify individual amino acids that had a positive effect on stability without compromising function. In phase II, amino acids shown to have positive effect in phase I, were combined to find even better combinations. Finally in phase Ill, data from phase I and II were confirmed and the effect of different N-terminal tags was investigated. In all three phases, the proteins were expressed in the same E coli system, using the same vector and purification protocol. All variants were expressed, purified and analysed in parallel, using similar protocols and procedure, within each phase. The analysis panel of each phase is summarized in Table 1. Amino acid and DNA sequence of all constructs can be found below.

TABLE 1 Analyses performed in the different phases of the A1M variant project phase phase phase Analysis I II III 1 SDS-PAGE (identifty, purity) x x x 2 Absorbance 280 nm (quantity) x x x 3 Circular Dichroism (identity) x 4 PAGE (aggregation analysis) x x x 5 SEC-FPLC (aggregation analysis) x 6 DLS (aggregation analysis) x x 7 RP-HPLC (purity, aggregation analysis) x 8 DSF (thermostability) x x 9 Shearing stability (DLS analysis) x x 10 Concentration stability (PAGE analysis) x x x 11 Concentration stability other buffers (PAGE x analysis) 12 Stability freeze thaw, prolonged storage in fridge, x RT, +37° C. (SEC-FPLC, ABTS reduction)* 13 Quantification of free thiol groups x 14 Reduction capacity of the ABTS radical x x x 15 Oxygen radical anti-oxidant capacity (ORAC) x 16 Reduction capacity of cytochrome c x 17 Reduction/binding capacity of free heme x x x 18 Binding capacity of heme-agarose x x x 19 Rescue of K562 cells from heme-induced cell x x death *Only performed on human wt and the M8H4DK-R66H + N1796D variant.

Amino acid sequence of all constructs: 60. M8H4DK-Human wt (rhA1M) (SEQ ID NO: 9) MHHHHHHHHDDDDKGPVPTPPDNIQVQENFNISRIYGKWYNLAIGSTCPWLKKIM-DRMTVSTLVLGEGATEAEISMT STRWRKGVCEETSGAYEKTDTDGKFLYHKSKWNITMESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAPQLRET LLQDFRVVAQGVGI-PEDSIFTMADRGECVPGEQEPEPILIPR 1.M8H5GIEGR-Mouse (SEQ ID NO: 24) MHHHHHHHHGGGGGIEGRDPASTLPDIQVQENFSESRI-YGKWYNLAVGSTCPWLSRIK-DKMSVQTLVLQEGATETE ISMTSTRWRRGVCEEITGAYQKTDIDGKFLYHKSKWNITLESYVVHTNYDEYAIFLTKKSSHHHGLTI-TAKLYGREP QLRDSLLQEFKDVALNVGISENSIIFMPDRGECVPGDREVEPTSIAR 2. M8H5GIEGR-Naked Mole rat (SEQ ID NO: 25) MHHHHHHHHGGGGGIEGRNPVPMPPDNIQVQENFDESRI-YGKWFNLATGSTCPWLKRIK-DRLSVSTMVLGKGTTET QISTTHTHWRQGVCQETSGVYKKTDTAGKFLYHKSKWNVTMESYVVHTNYDEYAIILTKKFSHHHGPTITAKLYGREP RLRDSLLQEFREMALGVGI-PEDSIFTMANRGECVPGDQAPESTPAPR 3. M8H5GIEGR-Frog (SEQ ID NO: 26) MHHHHHHHHGGGGGIEGRCSPIQPEDNIQIQENFDLQRIYGKWYDIAIGSTCK-WLKHH-KEKFNMGTLELSDGETDG EVRIVNTRMRHGTCSQIVGSYQKTETPGKFDYFNARWGTTIQNYIVFTNYNEYVIMQMRKKKGSETTTTVKLYGRSPD LRPTLVDEFRQFALAQGI-PEDSIVMLPNNGECSPGEIEVRPRR 4. M8H5GIEGR-Chicken (SEQ ID NO: 27) MHHHHHHHHGGGGGIEGRTPVGDQDEDIQVQENFEPERMYGKWYDVAVGTTCK-WMKNYKEKFSMGTLVLGPGPSADQ ISTISTRLRQGDCKRVSGEYQKTDTPGKYTYYNPKWDVSIKSYVLRTNYEEYAVILMKKTSNFGPTTTLKLYGRSPEL REEL-TEAFQQLALEMGIPADSVFILANKGECVPQETATAPER 5. M8H5GIEGR-Rabbit (SEQ ID NO: 28) MHHHHHHHHGGGGGIEGRDPVPTLPDDIQVQENFELSRI-YGKWYNLAVGSTCPWLKRIK-DRMAVSTLVLGEGTSET EISMTSTHWRRGVCEEISGAYEKTDTDGKFLYHKAKWNLTMESYVVHTNYDEYAIFLTKKFSRRHGPTITAKLYGREP QLRESLLQE-FREVALGVGIPENSIFTMIDRGECVPGQQEPKPAPVLR 6. M8H5GIEGR-SQ Monkey (SEQ ID NO: 29) MHHHHHHHHGGGGGIEGRSPVPTPPEGIQVQENFNLSRIYGKWYNLAIGSTCPWLK-KIMDRL-KVSTLVLEEGATEA EISMTSTRWRKGFCEQTSWAYEKTDTDGKFLYHEPKWNVTMESYVAHTNYEEYAIFLTKKFSRHHGPTITAKLYGREP QLRESLLQDFRVVAQGVGI-PEDSIFTMANRGECVPGEQEPQPILHRR 7. M8H5GIEGR-Walrus (SEQ ID NO: 30) MHHHHHHHHGGGGGIEGRSPVLTPPDAIQVQENFDISRIYGKWFH-VAMGSTCPWLKKFMDRMSMSTLVLGEGATDGE ISMTSTRWRRGTCEEISGAYEKTSTNGKFLYHNPKWNITMESYVVHTDYDEYAIFLTKKFSRHHGPTI-TAKLYGRQP QLRESLLEEFRELALGVGIPEDSIFTMANKGECVPGEQEPEPSPHMR 8. M8H5GIEGR-Manatee (SEQ ID NO: 31) MHHHHHHHHGGGGGIEGRSPVKTPLNDIQVQENFDLPRIYGKWFNIAIG-STCQWLKRLKAG-PTMSTLVLGEGATDT EISTTSTRWRKGFCEEISGAYEKTDTAGKFLYHGSKWNVTLESYVVHTNYDEYAIFLIKKFSRYGLTITAKLYGRQPQ VRESLLEEFREFALGVGI-PEDSIFTTADKGECVPGEQEPEPTAALR 9. M8H5GIEGR-Plaice (SEQ ID NO: 32) MHHHHHHHHGGGGGIEGRLPVLPEP-LYPTQENFDLTRFVGTWHDVALTSSCPHMQRN-RADAAIGKLVLEKDTGNKL KVTRTRLRHGTCVEMSGEYELTSTPGRIFYHIDRWDADVDAYVVHTNYDEYAIIIMSKQKTSGENSTSLKLYSRTMSV RDTVLDDFKTLVRHQGMSDDTIIIKQNKGDCIPGEQVEEAPSQPEPKR 10. M8H5GIEGR-Orangutan (SEQ ID NO: 33) MHHHHHHHHGGGGGIEGRGPVPTPPDNIQVQENFNISRIYGKWYNLAIGSTCPWLK-KIM-DRMTVSTLVLGEGATEA EISMTSTRWRKGVCEETSGAYEKTDTDGKFLYHKSKWNITMESYVVHTNYDEYAIFLTKKFSRRHGPTITAKLYGRAP QLRETLLQDFRVVAQGVGI-PEDSIFTMADRGECVPGEQEPEPILIPR 11. M8H5GIEGR-Human P35K (SEQ ID NO: 34) MHHHHHHHHGGGGGIEGRGPVPTPPDNIQVQENFNISRIYGKWYNLAIGSTCKWLK-KIM-DRMTVSTLVLGEGATEA EISMTSTRWRKGVCEETSGAYEKTDTDGKFLYHKSKWNITMESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAP QLRETLLQDFRVVAQGVGI-PEDSIFTMADRGECVPGEQEPEPILIPR 12. M8H5GIEGR-Human M41K (SEQ ID NO: 35) MHHHHHHHHGGGGGIEGRGPVPTPPDNIQVQENFNISRIYGKWYNLAIGSTCPWLK-KIK-DRMTVSTLVLGEGATEA EISMTSTRWRKGVCEETSGAYEKTDTDGKFLYHKSKWNITMESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAP QLRETLLQDFRVVAQGVGI-PEDSIFTMADRGECVPGEQEPEPILIPR 13. M8H5GIEGR-Human R66H (SEQ ID NO: 36) MHHHHHHHHGGGGGIEGRGPVPTPPDNIQVQENFNISRIYGKWYNLAIGSTCPWLK-KIM-DRMTVSTLVLGEGATEA EISMTSTHWRKGVCEETSGAYEKTDTDGKFLYHKSKWNITMESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAP QLRETLLQDFRVVAQGVGI-PEDSIFTMADRGECVPGEQEPEPILIPR 14. M8H5GIEGR-Human T75K (SEQ ID NO: 37) MHHHHHHHHGGGGGIEGRGPVPTPPDNIQVQENFNISRIYGKWYNLAIGSTCPWLK-KIM-DRMTVSTLVLGEGATEA EISMTSTRWRKGVCEEKSGAYEKTDTDGKFLYHKSKWNITMESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAP QLRETLLQDFRVVAQGVGI-PEDSIFTMADRGECVPGEQEPEPILIPR 15. M8H5GIEGR-Human T75Y (SEQ ID NO: 38) MHHHHHHHHGGGGGIEGRGPVPTPPDNIQVQENFNISRIYGKWYNLAIGSTCPWLK-KIM-DRMTVSTLVLGEGATEA EISMTSTRWRKGVCEEYSGAYEKTDTDGKFLYHKSKWNITMESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAP QLRETLLQDFRVVAQGVGI-PEDSIFTMADRGECVPGEQEPEPILIPR 16. M8H5GIEGR-Human M99K (SEQ ID NO: 39) MHHHHHHHHGGGGGIEGRGPVPTPPDNIQVQENFNISRIYGKWYNLAIGSTCPWLK-KIM-DRMTVSTLVLGEGATEA EISMTSTRWRKGVCEETSGAYEKTDTDGKFLYHKSKWNITKESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAP QLRETLLQDFRVVAQGVGI-PEDSIFTMADRGECVPGEQEPEPILIPR 17. M8H5GIEGR-Human S101Y (SEQ ID NO: 40) MHHHHHHHHGGGGGIEGRGPVPTPPDNIQVQENFNISRIYGKWYNLAIGSTCPWLK-KIM-DRMTVSTLVLGEGATEA EISMTSTRWRKGVCEETSGAYEKTDTDGKFLYHKSKWNITMEYYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAP QLRETLLQDFRVVAQGVGI-PEDSIFTMADRGECVPGEQEPEPILIPR 18. M8H5GIEGR-Human K69.92.118.130R (SEQ ID NO: 41) MHHHHHHHHGGGGGIEGRGPVPTPPDNIQVQENFNISRIYGKWYNLAIGSTCPWLK-KIM-DRMTVSTLVLGEGATEA EISMTSTRWRRGVCEETSGAYEKTDTDGKFLYHRSKWNITMESYVVHTNYDEYAIFLTKRFSRHHGPTITARLYGRAP QLRETLLQDFRVVAQGVGI-PEDSIFTMADRGECVPGEQEPEPILIPR 19. M8H5GIEGR-Coelacanth (SEQ ID NO: 42) MHHHHHHHHGGGGGIEGRGSPLRDEDIQVQENFDLPRIYGKWYEIAI-ASTCPWVKNHKDKMFMGTMVLQEGEQSDRI STTSTRIRDGTCSQITGYYTLTTTPGKFAYHNSKWNLDVNSYVVHTNYDEYSIVMMQKYKSS-NSTTTVRLYGRTQEL RDSLHAEFKKFALDQGIDEDSIYILPKRDECVPGEPKAESLMAR 21. M8H5GIEGR-Human L89T (SEQ ID NO: 43) MHHHHHHHHGGGGGIEGRGPVPTPPDNIQVQENFNISRIYGKWYNLAIGSTCPWLK-KIM-DRMTVSTLVLGEGATEA EISMTSTRWRKGVCEETSGAYEKTDTDGKFTYHKSKWNITMESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAP QLRETLLQDFRVVAQGVGI-PEDSIFTMADRGECVPGEQEPEPILIPR 22. M8H5GIEGR-Human N1796D (SEQ ID NO: 44) MHHHHHHHHGGGGGIEGRGPVPTPPDNIQVQENFDISRIYGKWYNLAIGSTCPWLK-KIM-DRMTVSTLVLGEGATEA EISMTSTRWRKGVCEETSGAYEKTDTDGKFLYHKSKWDITMESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAP QLRETLLQDFRVVAQGVGI-PEDSIFTMADRGECVPGEQEPEPILIPR 23. M8H5GIEGR-Human T45K (SEQ ID NO: 45) MHHHHHHHHGGGGGIEGRGPVPTPPDNIQVQENFNISRIYGKWYNLAIGSTCPWLK-KIM-DRMKVSTLVLGEGATEA EISMTSTRWRKGVCEETSGAYEKTDTDGKFLYHKSKWNITMESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAP QLRETLLQDFRVVAQGVGI-PEDSIFTMADRGECVPGEQEPEPILIPR 24. M8H5GIEGR-Human A135E (SEQ ID NO: 46) MHHHHHHHHGGGGGIEGRGPVPTPPDNIQVQENFNISRIYGKWYNLAIGSTCPWLK-KIM-DRMTVSTLVLGEGATEA EISMTSTRWRKGVCEETSGAYEKTDTDGKFLYHKSKWNITMESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGREP QLRETLLQDFRVVAQGVGI-PEDSIFTMADRGECVPGEQEPEPILIPR 25. M8H5GIEGR-Human V170S (SEQ ID NO: 47) MHHHHHHHHGGGGGIEGRGPVPTPPDNIQVQENFNISRIYGKWYNLAIGSTCPWLK-KIM-DRMTVSTLVLGEGATEA EISMTSTRWRKGVCEETSGAYEKTDTDGKFLYHKSKWNITMESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAP QLRETLLQDFRVVAQGVGI-PEDSIFTMADRGECSPGEQEPEPILIPR 26. M8H5GIEGR-Human V148D (SEQ ID NO: 48) MHHHHHHHHGGGGGIEGRGPVPTPPDNIQVQENFNISRIYGKWYNLAIGSTCPWLK-KIM-DRMTVSTLVLGEGATEA EISMTSTRWRKGVCEETSGAYEKTDTDGKFLYHKSKWNITMESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAP QLRETLLQDFRDVAQGVGI-PEDSIFTMADRGECVPGEQEPEPILIPR 27. M8H5GIEGR-Human G172Q (SEQ ID NO: 49) MHHHHHHHHGGGGGIEGRGPVPTPPDNIQVQENFNISRIYGKWYNLAIGSTCPWLK-KIM-DRMTVSTLVLGEGATEA EISMTSTRWRKGVCEETSGAYEKTDTDGKFLYHKSKWNITMESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAP QLRETLLQDFRVVAQGVGI-PEDSIFTMADRGECVPQEQEPEPILIPR 33. M8H4DK-Human M41K + R66H (SEQ ID NO: 50) MHHHHHHHHDDDDKGPVPTPPDNIQVQENFNISRIYGKWYNLAIGSTCPWLKKIK-DRMTVSTLVLGEGATEAEISMT STHWRKGVCEETSGAYEKTDTDGKFLYHKSKWNITMESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAPQLRET LLQDFRVVAQGVGI-PEDSIFTMADRGECVPGEQEPEPILIPR 34. M8H4DK-Human M41K + N1796D (SEQ ID NO: 51) MHHHHHHHHDDDDKGPVPTPPDNIQVQENFDISRIYGKWYNLAIGSTCPWLKKIK-DRMTVSTLVLGEGATEAEISMT STRWRKGVCEETSGAYEKTDTDGKFLYHKSKWDITMESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAPQLRET LLQDFRVVAQGVGI-PEDSIFTMADRGECVPGEQEPEPILIPR 35. M8H4DK-Human R66H + N1796D (SEQ ID NO: 52) MHHHHHHHHDDDDKGPVPTPPDNIQVQENFDISRIYGKWYNLAIGSTCPWLKKIM-DRMTVSTLVLGEGATEAEISMT STHWRKGVCEETSGAYEKTDTDGKFLYHKSKWDITMESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAPQLRET LLQDFRVVAQGVGI-PEDSIFTMADRGECVPGEQEPEPILIPR 36. M8H4DK-Human M41K + R66H + N1796D (SEQ ID NO: 53) MHHHHHHHHDDDDKGPVPTPPDNIQVQENFDISRIYGKWYNLAIGSTCPWLKKIK-DRMTVSTLVLGEGATEAEISMT STHWRKGVCEETSGAYEKTDTDGKFLYHKSKWDITMESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAPQLRET LLQDFRVVAQGVGI-PEDSIFTMADRGECVPGEQEPEPILIPR 37. M8H4DK-Human M41K (SEQ ID NO: 8) MHHHHHHHHDDDDKGPVPTPPDNIQVQENFNISRIYGKWYNLAIGSTCPWLKKIK-DRMTVSTLVLGEGATEAEISMT STRWRKGVCEETSGAYEKTDTDGKFLYHKSKWNITMESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAPQLRET LLQDFRVVAQGVGI-PEDSIFTMADRGECVPGEQEPEPILIPR 38. M8H4DK-Human R66H (SEQ ID NO: 54) MHHHHHHHHDDDDKGPVPTPPDNIQVQENFNISRIYGKWYNLAIGSTCPWLKKIM-DRMTVSTLVLGEGATEAEISMT STHWRKGVCEETSGAYEKTDTDGKFLYHKSKWNITMESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAPQLRET LLQDFRVVAQGVGI-PEDSIFTMADRGECVPGEQEPEPILIPR 39.M8H4DK-Human N1796D (SEQ ID NO: 55) MHHHHHHHHDDDDKGPVPTPPDNIQVQENFDISRIYGKWYNLAIGSTCPWLKKIM-DRMTVSTLVLGEGATEAEISMT STRWRKGVCEETSGAYEKTDTDGKFLYHKSKWDITMESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAPQLRET LLQDFRVVAQGVGI-PEDSIFTMADRGECVPGEQEPEPILIPR 40. M8H-Human wt (SEQ ID NO: 56) MHHHHHHHHGPVPTPPDNIQVQENFNISRIYGKWYNLAIGSTCPWLKKIM-DRMTVSTLVLGEGATEAEISMTSTRWR KGVCEETSGAYEKTDTDGKFLYHKSKWNITMESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAPQLRETLLQDF RVVAQGVGI-PEDSIFTMADRGECVPGEQEPEPILIPR 41. M8H-Human R66H + N1796D (SEQ ID NO: 57) MHHHHHHHHGPVPTPPDNIQVQENFDISRIYGKWYNLAIGSTCPWLKKIM-DRMTVSTLVLGEGATEAEISMTSTHWR KGVCEETSGAYEKTDTDGKFLYHKSKWDITMESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAPQLRETLLQDF RVVAQGVGI-PEDSIFTMADRGECVPGEQEPEPILIPR 42. untagged-Human R66H + N1796D (SEQ ID NO: 3) MGPVPTPPDNIQVQENFDISRIYGKWYNLAIGSTCPWLKKIMDRMTVSTLVLGEGA-TEAEISMTSTHWRKGVCEETS GAYEKTDTDGKFLYHKSKWDITMESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAPQLRETLLQDFRVVAQGVG IPEDSIFT-MADRGECVPGEQEPEPILIPR 61 untagged-Human wt (SEQ ID NO: 2) MGPVPTPPDNIQVQENFNISRIYGKWYNLAIGSTCPWLKKIMDRMTVSTLVLGEGA-TEAEISMTSTRWRKGVCEETS GAYEKTDTDGKFLYHKSKWNITMESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAPQLRETLLQDFRVVAQGVG IPEDSIFT-MADRGECVPGEQEPEPILIPR DNA sequence of all constructs: 60. M8H4DK-Human wt (SEQ ID NO: 58) ATGCATCACCATCACCATCACCATCACGATGACGATGACAAGGGCCCTGTGCCAACGCCGCCCGACAACATCCAAGTG CAGGAAAACTTCAATATCTCTCGGATCTATGGGAAGTGGTACAACCTGGCCATCGGTTCCACCTGCCCCTGGCTGAAG AAGATCATGGACAGGATGACAGTGAGCACGCTGGTGCTGGGAGAGGGCGCTACAGAGGCGGAGATCAGCATGACCAGC ACTCGTTGGCGGAAAGGTGTCTGTGAGGAGACGTCTGGAGCTTATGAGAAAACAGATACTGATGGGAAGTTTCTCTAT CACAAATCCAAATGGAACATAACCATGGAGTCCTATGTGGTCCACACCAACTATGATGAGTATGCCATTTTCCTGACC AAGAAATTCAGCCGCCATCATGGACCCACCATTACTGCCAAGCTCTACGGGCGGGCGCCGCAGCTGAGGGAAACTCTC CTGCAGGACTTCAGAGTGGTTGCCCAGGGTGTGGGCATCCCTGAGGACTCCATCTTCACCATGGCTGACCGAGGTGAA TGTGTCCCTGGGGAGCAGGAACCAGAGCCCATCTTAATCCCGAGATGA 1. M8H5GIEGR-Mouse (SEQ ID NO: 59) ATGCATCACCATCACCATCACCATCACGGTGGAGGAGGGGGTATCGAGGGCCGCGACCCTGCGTCAACACTGCCAGAT ATCCAGGTTCAGGAGAACTTCAGTGAGTCCCGGATCTATGGAAAATGGTACAACCTGGCGGTGGGATCCACCTGCCCG TGGCTGAGCCGCATTAAGGACAAGATGAGCGTGAGCACGCTGGTGCTGCAGGAGGGGGCGACAGAAACAGAGATCAGC ATGACCAGTACTCGATGGCGGAGAGGTGTCTGTGAGGAGATCACTGGGGCGTACCAGAAGACGGACATCGATGGAAAG TTCCTCTACCACAAATCCAAATGGAACATAACCTTGGAATCCTATGTGGTCCACACCAACTATGACGAATATGCCATT TTCCTTACCAAGAAGTCCAGCCACCACCACGGGCTCACCATCACTGCCAAGCTCTATGGTCGGGAGCCACAGCTGAGG GACAGCCTTCTGCAGGAGTTCAAGGATGTGGCCCTGAATGTGGGCATCTCTGAGAACTCCATCATTTTTATGCCTGAC AGAGGGGAATGTGTCCCTGGGGATCGGGAGGTGGAGCCCACATCAATTGCCAGATGA 2. M8H5GIEGR-Naked Mole rat (SEQ ID NO: 60) ATGCATCACCATCACCATCACCATCACGGTGGAGGAGGGGGTATCGAGGGCCGCAATCCTGTGCCGATGCCGCCAGAC AACATCCAAGTGCAGGAGAACTTTGATGAATCCCGGATCTATGGGAAATGGTTCAACCTGGCTACGGGCTCCACGTGC CCGTGGCTGAAGAGGATCAAAGACAGGCTGAGTGTGAGCACAATGGTGCTGGGCAAGGGGACCACGGAGACACAGATC AGCACAACCCACACCCACTGGCGGCAAGGGGTGTGCCAGGAGACCTCAGGGGTTTACAAGAAAACAGACACGGCTGGG AAGTTCCTCTACCACAAGTCCAAATGGAATGTAACCATGGAGTCCTATGTGGTCCACACCAACTATGATGAGTATGCC ATCATTCTAACTAAGAAGTTCAGCCACCACCATGGACCGACCATTACTGCCAAGCTCTATGGGAGAGAGCCGCGGCTG AGAGACAGCCTCCTGCAGGAATTCAGGGAGATGGCCCTGGGCGTAGGCATCCCCGAGGATTCCATCTTCACAATGGCC AACAGAGGGGAATGTGTCCCTGGTGACCAGGCACCAGAGTCCACCCCAGCCCCGAGGTGA 3. M8H5GIEGR-Frog (SEQ ID NO: 61) ATGCATCACCATCACCATCACCATCACGGTGGAGGAGGGGGTATCGAGGGCCGCTGCAGCCCAATCCAGCCAGAGGAC AATATCCAGATCCAGGAGAACTTTGATCTCCAGAGGATTTATGGCAAATGGTACGACATTGCCATCGGCTCCACCTGC AAATGGCTGAAGCACCACAAGGAAAAGTTCAACATGGGGACACTGGAGCTTAGCGATGGGGAGACCGACGGGGAGGTG CGGATTGTGAACACAAGGATGAGGCACGGAACCTGCTCTCAGATTGTTGGGTCCTATCAGAAGACAGAGACCCCAGGG AAGTTCGACTATTTCAACGCACGGTGGGGAACCACGATCCAAAACTACATTGTCTTCACTAACTACAATGAGTATGTC ATCATGCAGATGAGGAAGAAGAAGGGATCGGAGACCACCACGACCGTCAAGCTGTATGGGCGGAGCCCAGACTTGCGT CCGACCCTCGTTGATGAATTCAGGCAGTTTGCCTTGGCTCAGGGCATTCCTGAAGACTCCATCGTGATGCTACCTAAC AATGGTGAGTGCTCTCCAGGGGAAATAGAAGTGAGACCACGGAGATGA 4. M8H5GIEGR-Chicken (SEQ ID NO: 62) ATGCATCACCATCACCATCACCATCACGGTGGAGGAGGGGGTATCGAGGGCCGCACGCCTGTTGGGGACCAGGATGAG GACATTCAAGTGCAAGAGAATTTTGAGCCTGAGCGGATGTATGGGAAATGGTATGACGTAGCTGTTGGCACCACCTGC AAGTGGATGAAGAACTACAAGGAGAAGTTCAGCATGGGCACACTGGTGCTGGGCCCCGGCCCCAGCGCTGACCAGATC AGTACCATCAGCACCAGGCTGCGGCAAGGTGACTGCAAACGTGTCTCAGGAGAGTACCAGAAAACTGACACCCCTGGC AAATACACCTACTATAACCCCAAGTGGGATGTGTCTATCAAGTCCTACGTGCTTCGCACCAACTATGAAGAATACGCA GTCATTCTGATGAAGAAGACAAGTAATTTTGGCCCAACCACCACACTGAAGCTGTATGGGAGAAGCCCAGAGCTGCGG GAAGAGCTCACCGAGGCTTTCCAGCAGCTGGCTCTGGAGATGGGCATCCCTGCAGATTCCGTCTTCATCCTGGCCAAC AAAGGTGAATGTGTCCCACAGGAGACTGCCACTGCCCCTGAGAGGTGA 5. M8H5GIEGR-Rabbit (SEQ ID NO: 63) ATGCATCACCATCACCATCACCATCACGGTGGAGGAGGGGGTATCGAGGGCCGCGACCCCGTGCCCACCCTGCCGGAC GACATCCAAGTGCAGGAGAACTTCGAGCTCTCTCGGATCTACGGGAAATGGTACAACCTGGCTGTGGGGTCCACCTGC CCGTGGCTGAAGAGGATCAAGGACAGGATGGCCGTGAGCACGCTGGTGCTGGGAGAGGGGACGAGCGAGACGGAGATC AGCATGACCAGCACGCACTGGCGGAGGGGCGTCTGTGAGGAGATCTCCGGGGCCTATGAGAAAACGGACACTGACGGG AAGTTCCTGTACCACAAAGCCAAATGGAACTTAACCATGGAGTCCTACGTGGTGCACACCAACTACGATGAGTATGCC ATTTTTCTCACCAAGAAATTCAGCCGCCGCCACGGCCCCACCATCACCGCCAAGCTCTATGGGCGGGAGCCGCAGCTG AGGGAGAGCCTCCTGCAGGAGTTCAGGGAGGTGGCTCTCGGGGTGGGGATCCCCGAGAACTCCATCTTCACCATGATC GACAGAGGGGAATGTGTGCCCGGGCAGCAGGAACCAAAGCCTGCCCCCGTGTTGAGATGA 6. M8H5GIEGR-SQ Monkey (SEQ ID NO: 64) ATGCATCACCATCACCATCACCATCACGGTGGAGGAGGGGGTATCGAGGGCCGCAGCCCAGTGCCGACGCCGCCCGAA GGCATTCAAGTGCAGGAAAACTTCAATCTCTCTCGGATCTACGGCAAGTGGTACAACCTGGCCATCGGTTCCACCTGC CCCTGGCTAAAGAAGATCATGGACAGGTTGAAAGTGAGCACGCTGGTGCTGGAAGAGGGCGCCACGGAGGCGGAGATC AGCATGACCAGCACTCGCTGGCGGAAAGGTTTCTGTGAGCAGACCTCTTGGGCTTATGAGAAAACAGATACTGATGGG AAGTTTCTCTATCACGAACCCAAATGGAACGTAACCATGGAGTCCTATGTGGCCCACACCAACTATGAGGAGTATGCC ATTTTCCTGACCAAGAAATTCAGCCGCCATCATGGACCCACCATTACTGCCAAGCTCTATGGGCGGGAGCCACAGCTG AGGGAAAGCCTCCTGCAGGACTTCAGAGTGGTTGCCCAGGGTGTGGGCATCCCTGAGGATTCCATCTTCACCATGGCT AACCGAGGTGAATGCGTCCCTGGGGAGCAGGAACCACAGCCCATCCTACACCGGAGATGA 7. M8H5GIEGR-Walrus (SEQ ID NO: 65) ATGCATCACCATCACCATCACCATCACGGTGGAGGAGGGGGTATCGAGGGCCGCAGTCCCGTGCTGACGCCGCCTGAC GCCATCCAAGTGCAAGAGAACTTCGACATCTCTCGGATCTACGGGAAGTGGTTTCATGTGGCCATGGGCTCCACCTGC CCGTGGCTGAAGAAGTTCATGGACAGGATGTCCATGAGCACGCTGGTGCTGGGCGAGGGGGCGACGGATGGGGAGATC AGCATGACCAGCACACGTTGGCGGAGAGGCACCTGTGAGGAGATCTCTGGGGCTTATGAGAAAACCAGCACTAACGGA AAGTTCCTCTATCATAATCCCAAATGGAACATCACCATGGAGTCCTATGTGGTCCACACCGACTATGATGAGTACGCC ATCTTTCTGACCAAGAAATTCAGCCGCCACCATGGGCCCACCATTACTGCCAAGCTCTATGGGCGACAGCCGCAGCTT CGAGAAAGCCTGCTGGAGGAGTTCAGGGAGCTTGCCTTGGGTGTGGGCATCCCCGAGGACTCCATCTTCACCATGGCC AACAAAGGTGAGTGTGTCCCTGGGGAGCAGGAACCAGAGCCCTCTCCACACATGAGGTGA 8. M8H5GIEGR-Manatee (SEQ ID NO: 66) ATGCATCACCATCACCATCACCATCACGGTGGAGGAGGGGGTATCGAGGGCCGCAGCCCAGTGAAAACACCACTCAAC GACATCCAAGTGCAGGAGAACTTTGACCTCCCTCGGATCTACGGGAAATGGTTCAACATAGCCATTGGCTCCACCTGC CAATGGCTGAAGAGGTTGAAGGCCGGGCCGACCATGAGCACCCTGGTCCTGGGAGAGGGAGCTACAGACACAGAGATC AGCACAACCAGCACTCGTTGGCGGAAAGGCTTCTGTGAGGAGATCTCTGGGGCATATGAGAAAACAGACACAGCTGGG AAGTTCCTTTATCACGGATCCAAATGGAATGTAACCTTGGAGTCCTATGTGGTCCACACCAACTATGATGAGTACGCC ATTTTTCTGACCAAGAAATTCAGCCGCTATGGACTCACCATTACTGCTAAGCTCTATGGGCGGCAGCCTCAGGTGAGG GAGAGCCTCCTGGAGGAGTTCAGGGAATTTGCCCTGGGTGTGGGCATCCCTGAGGATTCCATCTTCACCACGGCCGAC AAAGGTGAGTGTGTCCCTGGAGAGCAGGAGCCAGAACCCACCGCAGCCCTGAGATGA 9. M8H5GIEGR-Plaice (SEQ ID NO: 67) ATGCATCACCATCACCATCACCATCACGGTGGAGGAGGGGGTATCGAGGGCCGCCTCCCTGTGCTCCCTGAACCTCTT TACCCGACACAGGAGAACTTTGATCTGACCCGGTTTGTGGGGACATGGCACGATGTTGCCTTGACGAGCAGCTGCCCC CATATGCAGCGTAACAGGGCGGATGCAGCCATTGGTAAACTGGTTCTGGAGAAAGACACTGGAAACAAACTCAAGGTG ACACGAACTAGACTCAGACATGGAACATGTGTGGAGATGTCTGGAGAATATGAGTTAACCAGCACACCAGGACGAATC TTCTACCATATTGACAGGTGGGATGCAGACGTGGACGCCTACGTGGTTCACACCAACTACGACGAGTACGCAATTATA ATAATGAGCAAACAGAAAACATCGGGGGAGAACAGCACCTCACTCAAGCTGTACAGTCGGACGATGTCTGTGAGAGAC ACTGTGCTGGATGACTTCAAAACTCTGGTCAGACATCAGGGAATGAGTGACGACACCATTATCATCAAGCAGAACAAA GGTGACTGTATTCCTGGAGAGCAGGTGGAAGAAGCACCATCTCAGCCAGAGCCCAAGCGGTGA 10. M8H5GIEGR-Orangutan (SEQ ID NO: 68) ATGCATCACCATCACCATCACCATCACGGTGGAGGAGGGGGTATCGAGGGCCGCGGCCCTGTGCCGACGCCGCCCGAC AACATCCAAGTGCAGGAAAACTTCAATATCTCTCGGATCTATGGGAAGTGGTACAACCTGGCCATCGGTTCCACCTGC CCCTGGCTGAAGAAGATCATGGACAGGATGACAGTGAGCACCCTGGTGCTGGGAGAGGGCGCTACAGAGGCGGAGATC AGCATGACCAGCACTCGTTGGCGGAAAGGTGTCTGTGAGGAGACATCTGGAGCTTATGAGAAAACAGATACTGATGGG AAGTTTCTCTATCACAAATCCAAATGGAACATAACCATGGAGTCCTATGTGGTCCACACCAACTATGATGAGTATGCC ATTTTCCTGACCAAGAAATTCAGCCGCCGTCATGGACCCACCATTACTGCCAAGCTCTACGGGCGGGCGCCGCAGCTG AGGGAAACCCTCCTGCAGGACTTCAGAGTGGTTGCCCAGGGTGTGGGCATCCCTGAGGACTCCATCTTCACCATGGCT GACCGAGGTGAATGTGTCCCTGGGGAACAGGAACCAGAGCCCATCTTAATCCCGAGATGA 11. M8H5GIEGR-Human P35K (SEQ ID NO: 69) ATGCATCACCATCACCATCACCATCACGGTGGAGGAGGGGGTATCGAGGGCCGCGGCCCTGTGCCAACGCCGCCCGAC AACATCCAAGTGCAGGAAAACTTCAATATCTCTCGGATCTATGGGAAGTGGTACAACCTGGCCATCGGTTCCACCTGC AAATGGCTGAAGAAGATCATGGACAGGATGACAGTGAGCACGCTGGTGCTGGGAGAGGGCGCTACAGAGGCGGAGATC AGCATGACCAGCACTCGTTGGCGGAAAGGTGTCTGTGAGGAGACGTCTGGAGCTTATGAGAAAACAGATACTGATGGG AAGTTTCTCTATCACAAATCCAAATGGAACATAACCATGGAGTCCTATGTGGTCCACACCAACTATGATGAGTATGCC ATTTTCCTGACCAAGAAATTCAGCCGCCATCATGGACCCACCATTACTGCCAAGCTCTACGGGCGGGCGCCGCAGCTG AGGGAAACTCTCCTGCAGGACTTCAGAGTGGTTGCCCAGGGTGTGGGCATCCCTGAGGACTCCATCTTCACCATGGCT GACCGAGGTGAATGTGTCCCTGGGGAGCAGGAACCAGAGCCCATCTTAATCCCGAGATGA 12. M8H5GIEGR-Human M41K (SEQ ID NO: 70 ATGCATCACCATCACCATCACCATCACGGTGGAGGAGGGGGTATCGAGGGCCGCGGCCCTGTGCCAACGCCGCCCGAC AACATCCAAGTGCAGGAAAACTTCAATATCTCTCGGATCTATGGGAAGTGGTACAACCTGGCCATCGGTTCCACCTGC CCCTGGCTGAAGAAGATCAAAGACAGGATGACAGTGAGCACGCTGGTGCTGGGAGAGGGCGCTACAGAGGCGGAGATC AGCATGACCAGCACTCGTTGGCGGAAAGGTGTCTGTGAGGAGACGTCTGGAGCTTATGAGAAAACAGATACTGATGGG AAGTTTCTCTATCACAAATCCAAATGGAACATAACCATGGAGTCCTATGTGGTCCACACCAACTATGATGAGTATGCC ATTTTCCTGACCAAGAAATTCAGCCGCCATCATGGACCCACCATTACTGCCAAGCTCTACGGGCGGGCGCCGCAGCTG AGGGAAACTCTCCTGCAGGACTTCAGAGTGGTTGCCCAGGGTGTGGGCATCCCTGAGGACTCCATCTTCACCATGGCT GACCGAGGTGAATGTGTCCCTGGGGAGCAGGAACCAGAGCCCATCTTAATCCCGAGATGA 13. M8H5GIEGR-Human R66H (SEQ ID NO: 71) ATGCATCACCATCACCATCACCATCACGGTGGAGGAGGGGGTATCGAGGGCCGCGGCCCTGTGCCAACGCCGCCCGAC AACATCCAAGTGCAGGAAAACTTCAATATCTCTCGGATCTATGGGAAGTGGTACAACCTGGCCATCGGTTCCACCTGC CCCTGGCTGAAGAAGATCATGGACAGGATGACAGTGAGCACGCTGGTGCTGGGAGAGGGCGCTACAGAGGCGGAGATC AGCATGACCAGCACTCATTGGCGGAAAGGTGTCTGTGAGGAGACGTCTGGAGCTTATGAGAAAACAGATACTGATGGG AAGTTTCTCTATCACAAATCCAAATGGAACATAACCATGGAGTCCTATGTGGTCCACACCAACTATGATGAGTATGCC ATTTTCCTGACCAAGAAATTCAGCCGCCATCATGGACCCACCATTACTGCCAAGCTCTACGGGCGGGCGCCGCAGCTG AGGGAAACTCTCCTGCAGGACTTCAGAGTGGTTGCCCAGGGTGTGGGCATCCCTGAGGACTCCATCTTCACCATGGCT GACCGAGGTGAATGTGTCCCTGGGGAGCAGGAACCAGAGCCCATCTTAATCCCGAGATGA 14. M8H5GIEGR-Human T75K (SEQ ID NO: 72) ATGCATCACCATCACCATCACCATCACGGTGGAGGAGGGGGTATCGAGGGCCGCGGCCCTGTGCCAACGCCGCCCGAC AACATCCAAGTGCAGGAAAACTTCAATATCTCTCGGATCTATGGGAAGTGGTACAACCTGGCCATCGGTTCCACCTGC CCCTGGCTGAAGAAGATCATGGACAGGATGACAGTGAGCACGCTGGTGCTGGGAGAGGGCGCTACAGAGGCGGAGATC AGCATGACCAGCACTCGTTGGCGGAAAGGTGTCTGTGAGGAGAAATCTGGAGCTTATGAGAAAACAGATACTGATGGG AAGTTTCTCTATCACAAATCCAAATGGAACATAACCATGGAGTCCTATGTGGTCCACACCAACTATGATGAGTATGCC ATTTTCCTGACCAAGAAATTCAGCCGCCATCATGGACCCACCATTACTGCCAAGCTCTACGGGCGGGCGCCGCAGCTG AGGGAAACTCTCCTGCAGGACTTCAGAGTGGTTGCCCAGGGTGTGGGCATCCCTGAGGACTCCATCTTCACCATGGCT GACCGAGGTGAATGTGTCCCTGGGGAGCAGGAACCAGAGCCCATCTTAATCCCGAGATGA 15. M8H5GIEGR-Human T75Y (SEQ ID NO: 73) ATGCATCACCATCACCATCACCATCACGGTGGAGGAGGGGGTATCGAGGGCCGCGGCCCTGTGCCAACGCCGCCCGAC AACATCCAAGTGCAGGAAAACTTCAATATCTCTCGGATCTATGGGAAGTGGTACAACCTGGCCATCGGTTCCACCTGC CCCTGGCTGAAGAAGATCATGGACAGGATGACAGTGAGCACGCTGGTGCTGGGAGAGGGCGCTACAGAGGCGGAGATC AGCATGACCAGCACTCGTTGGCGGAAAGGTGTCTGTGAGGAGTATTCTGGAGCTTATGAGAAAACAGATACTGATGGG AAGTTTCTCTATCACAAATCCAAATGGAACATAACCATGGAGTCCTATGTGGTCCACACCAACTATGATGAGTATGCC ATTTTCCTGACCAAGAAATTCAGCCGCCATCATGGACCCACCATTACTGCCAAGCTCTACGGGCGGGCGCCGCAGCTG AGGGAAACTCTCCTGCAGGACTTCAGAGTGGTTGCCCAGGGTGTGGGCATCCCTGAGGACTCCATCTTCACCATGGCT GACCGAGGTGAATGTGTCCCTGGGGAGCAGGAACCAGAGCCCATCTTAATCCCGAGATGA 16. M8H5GIEGR-Human M99K (SEQ ID NO: 74) ATGCATCACCATCACCATCACCATCACGGTGGAGGAGGGGGTATCGAGGGCCGCGGCCCTGTGCCAACGCCGCCCGAC AACATCCAAGTGCAGGAAAACTTCAATATCTCTCGGATCTATGGGAAGTGGTACAACCTGGCCATCGGTTCCACCTGC CCCTGGCTGAAGAAGATCATGGACAGGATGACAGTGAGCACGCTGGTGCTGGGAGAGGGCGCTACAGAGGCGGAGATC AGCATGACCAGCACTCGTTGGCGGAAAGGTGTCTGTGAGGAGACGTCTGGAGCTTATGAGAAAACAGATACTGATGGG AAGTTTCTCTATCACAAATCCAAATGGAACATAACCAAAGAGTCCTATGTGGTCCACACCAACTATGATGAGTATGCC ATTTTCCTGACCAAGAAATTCAGCCGCCATCATGGACCCACCATTACTGCCAAGCTCTACGGGCGGGCGCCGCAGCTG AGGGAAACTCTCCTGCAGGACTTCAGAGTGGTTGCCCAGGGTGTGGGCATCCCTGAGGACTCCATCTTCACCATGGCT GACCGAGGTGAATGTGTCCCTGGGGAGCAGGAACCAGAGCCCATCTTAATCCCGAGATGA 17. M8H5GIEGR-Human S101Y (SEQ ID NO: 75) ATGCATCACCATCACCATCACCATCACGGTGGAGGAGGGGGTATCGAGGGCCGCGGCCCTGTGCCAACGCCGCCCGAC AACATCCAAGTGCAGGAAAACTTCAATATCTCTCGGATCTATGGGAAGTGGTACAACCTGGCCATCGGTTCCACCTGC CCCTGGCTGAAGAAGATCATGGACAGGATGACAGTGAGCACGCTGGTGCTGGGAGAGGGCGCTACAGAGGCGGAGATC AGCATGACCAGCACTCGTTGGCGGAAAGGTGTCTGTGAGGAGACGTCTGGAGCTTATGAGAAAACAGATACTGATGGG AAGTTTCTCTATCACAAATCCAAATGGAACATAACCATGGAGTATTATGTGGTCCACACCAACTATGATGAGTATGCC ATTTTCCTGACCAAGAAATTCAGCCGCCATCATGGACCCACCATTACTGCCAAGCTCTACGGGCGGGCGCCGCAGCTG AGGGAAACTCTCCTGCAGGACTTCAGAGTGGTTGCCCAGGGTGTGGGCATCCCTGAGGACTCCATCTTCACCATGGCT GACCGAGGTGAATGTGTCCCTGGGGAGCAGGAACCAGAGCCCATCTTAATCCCGAGATGA 18. M8H5GIEGR-Human K69.92.118.130R (SEQ ID NO: 76) ATGCATCACCATCACCATCACCATCACGGTGGAGGAGGGGGTATCGAGGGCCGCGGCCCTGTGCCAACGCCGCCCGAC AACATCCAAGTGCAGGAAAACTTCAATATCTCTCGGATCTATGGGAAGTGGTACAACCTGGCCATCGGTTCCACCTGC CCCTGGCTGAAGAAGATCATGGACAGGATGACAGTGAGCACGCTGGTGCTGGGAGAGGGCGCTACAGAGGCGGAGATC AGCATGACCAGCACTCGTTGGCGGCGTGGTGTCTGTGAGGAGACGTCTGGAGCTTATGAGAAAACAGATACTGATGGG AAGTTTCTCTATCACCGTTCCAAATGGAACATAACCATGGAGTCCTATGTGGTCCACACCAACTATGATGAGTATGCC ATTTTCCTGACCAAGCGTTTCAGCCGCCATCATGGACCCACCATTACTGCCCGTCTCTACGGGCGGGCGCCGCAGCTG AGGGAAACTCTCCTGCAGGACTTCAGAGTGGTTGCCCAGGGTGTGGGCATCCCTGAGGACTCCATCTTCACCATGGCT GACCGAGGTGAATGTGTCCCTGGGGAGCAGGAACCAGAGCCCATCTTAATCCCGAGATGA 19. M8H5GIEGR-Coelacanth (SEQ ID NO: 77) ATGCATCACCATCACCATCACCATCACGGTGGAGGAGGGGGTATCGAGGGCCGCGGAAGTCCCCTTCGAGATGAAGAC ATCCAAGTGCAGGAGAACTTTGACCTTCCCAGGATTTATGGAAAATGGTACGAAATTGCAATCGCTTCGACCTGTCCC TGGGTGAAGAATCACAAGGATAAGATGTTCATGGGAACTATGGTGCTACAAGAGGGAGAGCAGAGTGACCGGATCAGT ACCACCTCCACCCGAATCAGGGATGGAACCTGCTCACAGATCACTGGATATTACACGTTAACCACAACACCTGGGAAG TTCGCTTATCACAATTCTAAATGGAACTTGGATGTCAACAGTTATGTTGTTCACACTAACTATGACGAATACTCGATT GTGATGATGCAGAAATACAAAAGCTCTAACTCTACCACTACAGTCCGACTCTATGGAAGAACTCAAGAGCTACGAGAC AGCTTGCATGCCGAGTTCAAAAAGTTTGCTCTGGATCAGGGAATAGATGAGGACTCCATTTACATTCTGCCAAAAAGA GATGAATGTGTACCTGGTGAACCTAAAGCAGAATCTCTCATGGCACGTTGA 21. M8H5GIEGR-Human L89T (SEQ ID NO: 78) ATGCATCACCATCACCATCACCATCACGGTGGAGGAGGGGGTATCGAGGGCCGCGGCCCTGTGCCAACGCCGCCCGAC AACATCCAAGTGCAGGAAAACTTCAATATCTCTCGGATCTATGGGAAGTGGTACAACCTGGCCATCGGTTCCACCTGC CCCTGGCTGAAGAAGATCATGGACAGGATGACAGTGAGCACGCTGGTGCTGGGAGAGGGCGCTACAGAGGCGGAGATC AGCATGACCAGCACTCGTTGGCGGAAAGGTGTCTGTGAGGAGACGTCTGGAGCTTATGAGAAAACAGATACTGATGGG AAGTTTACCTATCACAAATCCAAATGGAACATAACCATGGAGTCCTATGTGGTCCACACCAACTATGATGAGTATGCC ATTTTCCTGACCAAGAAATTCAGCCGCCATCATGGACCCACCATTACTGCCAAGCTCTACGGGCGGGCGCCGCAGCTG AGGGAAACTCTCCTGCAGGACTTCAGAGTGGTTGCCCAGGGTGTGGGCATCCCTGAGGACTCCATCTTCACCATGGCT GACCGAGGTGAATGTGTCCCTGGGGAGCAGGAACCAGAGCCCATCTTAATCCCGAGATGA 22. M8H5GIEGR-Human N1796D (SEQ ID NO: 79) ATGCATCACCATCACCATCACCATCACGGTGGAGGAGGGGGTATCGAGGGCCGCGGCCCTGTGCCAACGCCGCCCGAC AACATCCAAGTGCAGGAAAACTTCGATATCTCTCGGATCTATGGGAAGTGGTACAACCTGGCCATCGGTTCCACCTGC CCCTGGCTGAAGAAGATCATGGACAGGATGACAGTGAGCACGCTGGTGCTGGGAGAGGGCGCTACAGAGGCGGAGATC AGCATGACCAGCACTCGTTGGCGGAAAGGTGTCTGTGAGGAGACGTCTGGAGCTTATGAGAAAACAGATACTGATGGG AAGTTTCTCTATCACAAATCCAAATGGGATATAACCATGGAGTCCTATGTGGTCCACACCAACTATGATGAGTATGCC ATTTTCCTGACCAAGAAATTCAGCCGCCATCATGGACCCACCATTACTGCCAAGCTCTACGGGCGGGCGCCGCAGCTG AGGGAAACTCTCCTGCAGGACTTCAGAGTGGTTGCCCAGGGTGTGGGCATCCCTGAGGACTCCATCTTCACCATGGCT GACCGAGGTGAATGTGTCCCTGGGGAGCAGGAACCAGAGCCCATCTTAATCCCGAGATGA 23. M8H5GIEGR-Human T45K (SEQ ID NO: 80) ATGCATCACCATCACCATCACCATCACGGTGGAGGAGGGGGTATCGAGGGCCGCGGCCCTGTGCCAACGCCGCCCGAC AACATCCAAGTGCAGGAAAACTTCAATATCTCTCGGATCTATGGGAAGTGGTACAACCTGGCCATCGGTTCCACCTGC CCCTGGCTGAAGAAGATCATGGACAGGATGAAAGTGAGCACGCTGGTGCTGGGAGAGGGCGCTACAGAGGCGGAGATC AGCATGACCAGCACTCGTTGGCGGAAAGGTGTCTGTGAGGAGACGTCTGGAGCTTATGAGAAAACAGATACTGATGGG AAGTTTCTCTATCACAAATCCAAATGGAACATAACCATGGAGTCCTATGTGGTCCACACCAACTATGATGAGTATGCC ATTTTCCTGACCAAGAAATTCAGCCGCCATCATGGACCCACCATTACTGCCAAGCTCTACGGGCGGGCGCCGCAGCTG AGGGAAACTCTCCTGCAGGACTTCAGAGTGGTTGCCCAGGGTGTGGGCATCCCTGAGGACTCCATCTTCACCATGGCT GACCGAGGTGAATGTGTCCCTGGGGAGCAGGAACCAGAGCCCATCTTAATCCCGAGATGA 24. M8H5GIEGR-Human A135E (SEQ ID NO: 81) ATGCATCACCATCACCATCACCATCACGGTGGAGGAGGGGGTATCGAGGGCCGCGGCCCTGTGCCAACGCCGCCCGAC AACATCCAAGTGCAGGAAAACTTCAATATCTCTCGGATCTATGGGAAGTGGTACAACCTGGCCATCGGTTCCACCTGC CCCTGGCTGAAGAAGATCATGGACAGGATGACAGTGAGCACGCTGGTGCTGGGAGAGGGCGCTACAGAGGCGGAGATC AGCATGACCAGCACTCGTTGGCGGAAAGGTGTCTGTGAGGAGACGTCTGGAGCTTATGAGAAAACAGATACTGATGGG AAGTTTCTCTATCACAAATCCAAATGGAACATAACCATGGAGTCCTATGTGGTCCACACCAACTATGATGAGTATGCC ATTTTCCTGACCAAGAAATTCAGCCGCCATCATGGACCCACCATTACTGCCAAGCTCTACGGGCGGGAACCGCAGCTG AGGGAAACTCTCCTGCAGGACTTCAGAGTGGTTGCCCAGGGTGTGGGCATCCCTGAGGACTCCATCTTCACCATGGCT GACCGAGGTGAATGTGTCCCTGGGGAGCAGGAACCAGAGCCCATCTTAATCCCGAGATGA 25. M8H5GIEGR-Human V170S (SEQ ID NO: 82) ATGCATCACCATCACCATCACCATCACGGTGGAGGAGGGGGTATCGAGGGCCGCGGCCCTGTGCCAACGCCGCCCGAC AACATCCAAGTGCAGGAAAACTTCAATATCTCTCGGATCTATGGGAAGTGGTACAACCTGGCCATCGGTTCCACCTGC CCCTGGCTGAAGAAGATCATGGACAGGATGACAGTGAGCACGCTGGTGCTGGGAGAGGGCGCTACAGAGGCGGAGATC AGCATGACCAGCACTCGTTGGCGGAAAGGTGTCTGTGAGGAGACGTCTGGAGCTTATGAGAAAACAGATACTGATGGG AAGTTTCTCTATCACAAATCCAAATGGAACATAACCATGGAGTCCTATGTGGTCCACACCAACTATGATGAGTATGCC ATTTTCCTGACCAAGAAATTCAGCCGCCATCATGGACCCACCATTACTGCCAAGCTCTACGGGCGGGCGCCGCAGCTG AGGGAAACTCTCCTGCAGGACTTCAGAGTGGTTGCCCAGGGTGTGGGCATCCCTGAGGACTCCATCTTCACCATGGCT GACCGAGGTGAATGTTCTCCTGGGGAGCAGGAACCAGAGCCCATCTTAATCCCGAGATGA 26. M8H5GIEGR-Human V148D (SEQ ID NO: 83) ATGCATCACCATCACCATCACCATCACGGTGGAGGAGGGGGTATCGAGGGCCGCGGCCCTGTGCCAACGCCGCCCGAC AACATCCAAGTGCAGGAAAACTTCAATATCTCTCGGATCTATGGGAAGTGGTACAACCTGGCCATCGGTTCCACCTGC CCCTGGCTGAAGAAGATCATGGACAGGATGACAGTGAGCACGCTGGTGCTGGGAGAGGGCGCTACAGAGGCGGAGATC AGCATGACCAGCACTCGTTGGCGGAAAGGTGTCTGTGAGGAGACGTCTGGAGCTTATGAGAAAACAGATACTGATGGG AAGTTTCTCTATCACAAATCCAAATGGAACATAACCATGGAGTCCTATGTGGTCCACACCAACTATGATGAGTATGCC ATTTTCCTGACCAAGAAATTCAGCCGCCATCATGGACCCACCATTACTGCCAAGCTCTACGGGCGGGCGCCGCAGCTG AGGGAAACTCTCCTGCAGGACTTCAGAGATGTTGCCCAGGGTGTGGGCATCCCTGAGGACTCCATCTTCACCATGGCT GACCGAGGTGAATGTGTCCCTGGGGAGCAGGAACCAGAGCCCATCTTAATCCCGAGATGA 27. M8H5GIEGR-Human G172Q (SEQ ID NO: 84) ATGCATCACCATCACCATCACCATCACGGTGGAGGAGGGGGTATCGAGGGCCGCGGCCCTGTGCCAACGCCGCCCGAC AACATCCAAGTGCAGGAAAACTTCAATATCTCTCGGATCTATGGGAAGTGGTACAACCTGGCCATCGGTTCCACCTGC CCCTGGCTGAAGAAGATCATGGACAGGATGACAGTGAGCACGCTGGTGCTGGGAGAGGGCGCTACAGAGGCGGAGATC AGCATGACCAGCACTCGTTGGCGGAAAGGTGTCTGTGAGGAGACGTCTGGAGCTTATGAGAAAACAGATACTGATGGG AAGTTTCTCTATCACAAATCCAAATGGAACATAACCATGGAGTCCTATGTGGTCCACACCAACTATGATGAGTATGCC ATTTTCCTGACCAAGAAATTCAGCCGCCATCATGGACCCACCATTACTGCCAAGCTCTACGGGCGGGCGCCGCAGCTG AGGGAAACTCTCCTGCAGGACTTCAGAGTGGTTGCCCAGGGTGTGGGCATCCCTGAGGACTCCATCTTCACCATGGCT GACCGAGGTGAATGTGTCCCTCAGGAGCAGGAACCAGAGCCCATCTTAATCCCGAGATGA 33. M8H4DK-Human M41K + R66H (SEQ ID NO: 85) ATGCATCACCATCACCATCACCATCACGATGACGATGACAAGGGCCCTGTGCCAACGCCGCCCGACAACATCCAAGTG CAGGAAAACTTCAATATCTCTCGGATCTATGGGAAGTGGTACAACCTGGCCATCGGTTCCACCTGCCCCTGGCTGAAG AAGATCAAAGACAGGATGACAGTGAGCACGCTGGTGCTGGGAGAGGGCGCTACAGAGGCGGAGATCAGCATGACCAGC ACTCATTGGCGGAAAGGTGTCTGTGAGGAGACGTCTGGAGCTTATGAGAAAACAGATACTGATGGGAAGTTTCTCTAT CACAAATCCAAATGGAACATAACCATGGAGTCCTATGTGGTCCACACCAACTATGATGAGTATGCCATTTTCCTGACC AAGAAATTCAGCCGCCATCATGGACCCACCATTACTGCCAAGCTCTACGGGCGGGCGCCGCAGCTGAGGGAAACTCTC CTGCAGGACTTCAGAGTGGTTGCCCAGGGTGTGGGCATCCCTGAGGACTCCATCTTCACCATGGCTGACCGAGGTGAA TGTGTCCCTGGGGAGCAGGAACCAGAGCCCATCTTAATCCCGAGATGA 34. M8H4DK-Human M41K + N1796D (SEQ ID NO: 86) ATGCATCACCATCACCATCACCATCACGATGACGATGACAAGGGCCCTGTGCCAACGCCGCCCGACAACATCCAAGTG CAGGAAAACTTCGATATCTCTCGGATCTATGGGAAGTGGTACAACCTGGCCATCGGTTCCACCTGCCCCTGGCTGAAG AAGATCAAAGACAGGATGACAGTGAGCACGCTGGTGCTGGGAGAGGGCGCTACAGAGGCGGAGATCAGCATGACCAGC ACTCGTTGGCGGAAAGGTGTCTGTGAGGAGACGTCTGGAGCTTATGAGAAAACAGATACTGATGGGAAGTTTCTCTAT CACAAATCCAAATGGGATATAACCATGGAGTCCTATGTGGTCCACACCAACTATGATGAGTATGCCATTTTCCTGACC AAGAAATTCAGCCGCCATCATGGACCCACCATTACTGCCAAGCTCTACGGGCGGGCGCCGCAGCTGAGGGAAACTCTC CTGCAGGACTTCAGAGTGGTTGCCCAGGGTGTGGGCATCCCTGAGGACTCCATCTTCACCATGGCTGACCGAGGTGAA TGTGTCCCTGGGGAGCAGGAACCAGAGCCCATCTTAATCCCGAGATGA 35. M8H4DK-Human R66H + N1796D (SEQ ID NO: 87) ATGCATCACCATCACCATCACCATCACGATGACGATGACAAGGGCCCTGTGCCAACGCCGCCCGACAACATCCAAGTG CAGGAAAACTTCGATATCTCTCGGATCTATGGGAAGTGGTACAACCTGGCCATCGGTTCCACCTGCCCCTGGCTGAAG AAGATCATGGACAGGATGACAGTGAGCACGCTGGTGCTGGGAGAGGGCGCTACAGAGGCGGAGATCAGCATGACCAGC ACTCATTGGCGGAAAGGTGTCTGTGAGGAGACGTCTGGAGCTTATGAGAAAACAGATACTGATGGGAAGTTTCTCTAT CACAAATCCAAATGGGATATAACCATGGAGTCCTATGTGGTCCACACCAACTATGATGAGTATGCCATTTTCCTGACC AAGAAATTCAGCCGCCATCATGGACCCACCATTACTGCCAAGCTCTACGGGCGGGCGCCGCAGCTGAGGGAAACTCTC CTGCAGGACTTCAGAGTGGTTGCCCAGGGTGTGGGCATCCCTGAGGACTCCATCTTCACCATGGCTGACCGAGGTGAA TGTGTCCCTGGGGAGCAGGAACCAGAGCCCATCTTAATCCCGAGATGA 36. M8H4DK-Human M41K + R66H + N1796D (SEQ ID NO: 88) ATGCATCACCATCACCATCACCATCACGATGACGATGACAAGGGCCCTGTGCCAACGCCGCCCGACAACATCCAAGTG CAGGAAAACTTCGATATCTCTCGGATCTATGGGAAGTGGTACAACCTGGCCATCGGTTCCACCTGCCCCTGGCTGAAG AAGATCAAAGACAGGATGACAGTGAGCACGCTGGTGCTGGGAGAGGGCGCTACAGAGGCGGAGATCAGCATGACCAGC ACTCATTGGCGGAAAGGTGTCTGTGAGGAGACGTCTGGAGCTTATGAGAAAACAGATACTGATGGGAAGTTTCTCTAT CACAAATCCAAATGGGATATAACCATGGAGTCCTATGTGGTCCACACCAACTATGATGAGTATGCCATTTTCCTGACC AAGAAATTCAGCCGCCATCATGGACCCACCATTACTGCCAAGCTCTACGGGCGGGCGCCGCAGCTGAGGGAAACTCTC CTGCAGGACTTCAGAGTGGTTGCCCAGGGTGTGGGCATCCCTGAGGACTCCATCTTCACCATGGCTGACCGAGGTGAA TGTGTCCCTGGGGAGCAGGAACCAGAGCCCATCTTAATCCCGAGATGA 37. M8H4DK-Human M41K (SEQ ID NO: 89) ATGCATCACCATCACCATCACCATCACGATGACGATGACAAGGGCCCTGTGCCAACGCCGCCCGACAACATCCAAGTG CAGGAAAACTTCAATATCTCTCGGATCTATGGGAAGTGGTACAACCTGGCCATCGGTTCCACCTGCCCCTGGCTGAAG AAGATCAAAGACAGGATGACAGTGAGCACGCTGGTGCTGGGAGAGGGCGCTACAGAGGCGGAGATCAGCATGACCAGC ACTCGTTGGCGGAAAGGTGTCTGTGAGGAGACGTCTGGAGCTTATGAGAAAACAGATACTGATGGGAAGTTTCTCTAT CACAAATCCAAATGGAACATAACCATGGAGTCCTATGTGGTCCACACCAACTATGATGAGTATGCCATTTTCCTGACC AAGAAATTCAGCCGCCATCATGGACCCACCATTACTGCCAAGCTCTACGGGCGGGCGCCGCAGCTGAGGGAAACTCTC CTGCAGGACTTCAGAGTGGTTGCCCAGGGTGTGGGCATCCCTGAGGACTCCATCTTCACCATGGCTGACCGAGGTGAA TGTGTCCCTGGGGAGCAGGAACCAGAGCCCATCTTAATCCCGAGATGA 38. M8H4DK-Human R66H (SEQ ID NO: 90) ATGCATCACCATCACCATCACCATCACGATGACGATGACAAGGGCCCTGTGCCAACGCCGCCCGACAACATCCAAGTG CAGGAAAACTTCAATATCTCTCGGATCTATGGGAAGTGGTACAACCTGGCCATCGGTTCCACCTGCCCCTGGCTGAAG AAGATCATGGACAGGATGACAGTGAGCACGCTGGTGCTGGGAGAGGGCGCTACAGAGGCGGAGATCAGCATGACCAGC ACTCATTGGCGGAAAGGTGTCTGTGAGGAGACGTCTGGAGCTTATGAGAAAACAGATACTGATGGGAAGTTTCTCTAT CACAAATCCAAATGGAACATAACCATGGAGTCCTATGTGGTCCACACCAACTATGATGAGTATGCCATTTTCCTGACC AAGAAATTCAGCCGCCATCATGGACCCACCATTACTGCCAAGCTCTACGGGCGGGCGCCGCAGCTGAGGGAAACTCTC CTGCAGGACTTCAGAGTGGTTGCCCAGGGTGTGGGCATCCCTGAGGACTCCATCTTCACCATGGCTGACCGAGGTGAA TGTGTCCCTGGGGAGCAGGAACCAGAGCCCATCTTAATCCCGAGATGA 39. M8H4DK-Human N1796D (SEQ ID NO: 91) ATGCATCACCATCACCATCACCATCACGATGACGATGACAAGGGCCCTGTGCCAACGCCGCCCGACAACATCCAAGTG CAGGAAAACTTCGATATCTCTCGGATCTATGGGAAGTGGTACAACCTGGCCATCGGTTCCACCTGCCCCTGGCTGAAG AAGATCATGGACAGGATGACAGTGAGCACGCTGGTGCTGGGAGAGGGCGCTACAGAGGCGGAGATCAGCATGACCAGC ACTCGTTGGCGGAAAGGTGTCTGTGAGGAGACGTCTGGAGCTTATGAGAAAACAGATACTGATGGGAAGTTTCTCTAT CACAAATCCAAATGGGATATAACCATGGAGTCCTATGTGGTCCACACCAACTATGATGAGTATGCCATTTTCCTGACC AAGAAATTCAGCCGCCATCATGGACCCACCATTACTGCCAAGCTCTACGGGCGGGCGCCGCAGCTGAGGGAAACTCTC CTGCAGGACTTCAGAGTGGTTGCCCAGGGTGTGGGCATCCCTGAGGACTCCATCTTCACCATGGCTGACCGAGGTGAA TGTGTCCCTGGGGAGCAGGAACCAGAGCCCATCTTAATCCCGAGATGA 40. M8H-Human wt (SEQ ID NO: 92) ATGCATCACCATCACCATCACCATCACGGCCCTGTGCCAACGCCGCCCGACAACATCCAAGTGCAGGAAAACTTCAAT ATCTCTCGGATCTATGGGAAGTGGTACAACCTGGCCATCGGTTCCACCTGCCCCTGGCTGAAGAAGATCATGGACAGG ATGACAGTGAGCACGCTGGTGCTGGGAGAGGGCGCTACAGAGGCGGAGATCAGCATGACCAGCACTCGTTGGCGGAAA GGTGTCTGTGAGGAGACGTCTGGAGCTTATGAGAAAACAGATACTGATGGGAAGTTTCTCTATCACAAATCCAAATGG AACATAACCATGGAGTCCTATGTGGTCCACACCAACTATGATGAGTATGCCATTTTCCTGACCAAGAAATTCAGCCGC CATCATGGACCCACCATTACTGCCAAGCTCTACGGGCGGGCGCCGCAGCTGAGGGAAACTCTCCTGCAGGACTTCAGA GTGGTTGCCCAGGGTGTGGGCATCCCTGAGGACTCCATCTTCACCATGGCTGACCGAGGTGAATGTGTCCCTGGGGAG CAGGAACCAGAGCCCATCTTAATCCCGAGATGA 41. M8H-Human R66H + N1796D (SEQ ID NO: 93) ATGCATCACCATCACCATCACCATCACGGCCCTGTGCCAACGCCGCCCGACAACATCCAAGTGCAGGAAAACTTCGAT ATCTCTCGGATCTATGGGAAGTGGTACAACCTGGCCATCGGTTCCACCTGCCCCTGGCTGAAGAAGATCATGGACAGG ATGACAGTGAGCACGCTGGTGCTGGGAGAGGGCGCTACAGAGGCGGAGATCAGCATGACCAGCACTCATTGGCGGAAA GGTGTCTGTGAGGAGACGTCTGGAGCTTATGAGAAAACAGATACTGATGGGAAGTTTCTCTATCACAAATCCAAATGG GATATAACCATGGAGTCCTATGTGGTCCACACCAACTATGATGAGTATGCCATTTTCCTGACCAAGAAATTCAGCCGC CATCATGGACCCACCATTACTGCCAAGCTCTACGGGCGGGCGCCGCAGCTGAGGGAAACTCTCCTGCAGGACTTCAGA GTGGTTGCCCAGGGTGTGGGCATCCCTGAGGACTCCATCTTCACCATGGCTGACCGAGGTGAATGTGTCCCTGGGGAG CAGGAACCAGAGCCCATCTTAATCCCGAGATGA 42. untagged-Human R66H + N1796D (SEQ ID NO: 94) ATGGGCCCTGTGCCAACGCCGCCCGACAACATCCAAGTGCAGGAAAACTTCGATATCTCTCGGATCTATGGGAAGTGG TACAACCTGGCCATCGGTTCCACCTGCCCCTGGCTGAAGAAGATCATGGACAGGATGACAGTGAGCACGCTGGTGCTG GGAGAGGGCGCTACAGAGGCGGAGATCAGCATGACCAGCACTCATTGGCGGAAAGGTGTCTGTGAGGAGACGTCTGGA GCTTATGAGAAAACAGATACTGATGGGAAGTTTCTCTATCACAAATCCAAATGGGATATAACCATGGAGTCCTATGTG GTCCACACCAACTATGATGAGTATGCCATTTTCCTGACCAAGAAATTCAGCCGCCATCATGGACCCACCATTACTGCC AAGCTCTACGGGCGGGCGCCGCAGCTGAGGGAAACTCTCCTGCAGGACTTCAGAGTGGTTGCCCAGGGTGTGGGCATC CCTGAGGACTCCATCTTCACCATGGCTGACCGAGGTGAATGTGTCCCTGGGGAGCAGGAACCAGAGCCCATCTTAATC CCGAGATGA 61. untagged-Hu man wt (SEQ ID NO: 95) ATGGGCCCTGTGCCAACGCCGCCCGACAACATCCAAGTGCAGGAAAACTTCAATATCTCTCGGATCTATGGGAAGTGG TACAACCTGGCCATCGGTTCCACCTGCCCCTGGCTGAAGAAGATCATGGACAGGATGACAGTGAGCACGCTGGTGCTG GGAGAGGGCGCTACAGAGGCGGAGATCAGCATGACCAGCACTCGTTGGCGGAAAGGTGTCTGTGAGGAGACGTCTGGA GCTTATGAGAAAACAGATACTGATGGGAAGTTTCTCTATCACAAATCCAAATGGAACATAACCATGGAGTCCTATGTG GTCCACACCAACTATGATGAGTATGCCATTTTCCTGACCAAGAAATTCAGCCGCCATCATGGACCCACCATTACTGCC AAGCTCTACGGGCGGGCGCCGCAGCTGAGGGAAACTCTCCTGCAGGACTTCAGAGTGGTTGCCCAGGGTGTGGGCATC CCTGAGGACTCCATCTTCACCATGGCTGACCGAGGTGAATGTGTCCCTGGGGAGCAGGAACCAGAGCCCATCTTAATC CCGAGATGA

Rationale of A1M Variant Constructions

Human wt-A1M, 11 A1M-homologues from various species, and 15 A1M-variants with point mutations were constructed, expressed, purified and analysed in phase I, i.e. a total of 27 A1M-variants (Table 2). The 11 A1M-homologues were selected as follows. A1M is well conserved between species. A1M sequences of different species were searched for in data bases (www.ncbi.nlm.nih.gov and www.uniprot.org). AMBP sequences from 67 different species were found. The sequences were investigated for presence of A1M-specific functional groups (K69, K92, K118, K130, Y22; Y132, H122 and H123), lipocalin motifs (SCR1, 2, 3) (see refs in Introduction) and predicted carbohydrate binding sites (Escribano et al., 1990). Five were classified as non-A1M and dismissed because they lacked cystein 34, three were dismissed because they lacked cystein 169, four because they were incomplete, and two because they had long, questionable, inserts. The amino acid sequences of the remaining 53 homologues were aligned and their suggested 3D structure were modelled by projecting their amino acid sequences on the crystal structure of human A1M (Meining and Skerra, 2012) to identify the location of individual amino acid side chains in the lipocalin loops or on the inside or outside of the pocket. The result of this was used for construction of point mutations affecting A1M-function as described below. The rationale for selection of the final 11 homologues (see Table 2) was a combination of wide-spread evolutionary representation, methodological feasibility, potentially increased environmental oxidative stress in the living habitat of the species, presence or absence of A1M-specific functional groups, and lack of glycosylation. The 15 A1M-variants with point mutations were selected as follows. Eight of the variants were mutated in strategic amino acids for functional properties and seven variants in exposed positions to improve stability/solubility (Table 2). The eight functional mutations were selected as they 1) occurred in other species in positions in the 3D-structural model (see above) that could potentially influence the function of A1M and/or 2) theoretically would lower the pKa of cystein 34 and/or 3) theoretically would provide an extra radical trapping site. Predicted data for all variants was calculated using the http://www.alphalyse.com/qpmaw_lite.html tool (Table 3).

TABLE 2 Variants expressed and analysed in A1M variants project phase I. Systematic Protein Gene Info Aim of N-terminal No* Name name sequence Identifier mutation Rationale tag 60 human wt Homo sapiens NP_001624 gi: 4502067 M8H4DK 1 mouse Mus musculus NP_031469 gi: 311703 Species only rodent, lab animal, we have M8H5GIEGR antibodies 2 naked mole- Heterocephalus XP_004885260 gi: 512843527 Species long-lived, low tumor frequency M8H5GIEGR rat glaber suggests good endogeneous antioxidation 3 frog Xenopus NP_001080820 gi: 147905774 Species no predicted carbohydrate suggests high M8H5GIEGR laevis solubility of polypeptide, 1 extra Cys, high pl 4 chicken Gallus gallus NP_001264627 gi: 478732996 Species only bird M8H5GIEGR 5 rabbit Oryctolagus XP_008271622 gi: 655878696 Species lab animal, we have antibodies M8H5GIEGR cuniculus 6 squirrel Saimiri XP_0039252551 gi: 403266141 Species two primates, less substitutions compared M8H5GIEGR monkey boliviensis to human, easier readout 7 walrus Odobenus XP_004397010 gi: 472354701 Species uneven oxygenation due to diving M8H5GIEGR rosmarus 8 manatee Trichechus XP_004372191 gi: 0471363267 Species uneven oxygenation due to diving M8H5GIEGR manatus 9 plaice Pleuronectes 2021284A gi: 1091607 Species uneven oxygenation due to diving M8H5GIEGR platessa 10 orangutan Pongo abelii NP_001127069 gi: 197102775 Species one substitution-H122R-in an interesting M8H5GIEGR position: reductase and heme-binding 11 human P35K Functional a) occurs in birds and frogs, b) may lower M8H5GIEGR pKa of C34, c) may be radical trapping site 12 human M41K Functional a) occurs in many species, b) may lower M8H5GIEGR pKa of C34, c) may be radical trapping site 13 human R66H Functional occurs in many species, c.f. rodents and M8H5GIEGR rabbits 14 human 175K Functional a) may lower pKa of C34, b) may be M8H5GIEGR radical trapping site 15 human T75Y Functional may be radical trapping site M8H5GIEGR 16 human M99K Functional a) may lower pKa of C34, b) may be M8H5GIEGR radical trapping site 17 human S101Y Functional may be radical trapping site M8H5GIEGR 18 human Functional may be radical trapping sites M8H5GIEGR K69, 92, 118, 130R 19 coelacanth Latimeria XP_ gi: 556972695 Species most primitive A1M-sequence identified M8H5GIEGR chalumnae 005994505.1 21 human L89T Solubility exposed position, increased hydrophilicity, M8H5GIEGR occurs in many species 22 human Solubility carbohydrate sites, increased hydrophilicity M8H5GIEGR N17, 96D 23 human T45K Solubility exposed position, increased charge, occurs M8H5GIEGR in many species 24 human Solubility exposed position, increased charge, occurs M8H5GIEGR A135E in many species 25 human Solubility exposed position, increased hydrophilicity, M8H5GIEGR V170S occurs in many species 26 human Solubility exposed position, increased hydrophilicity, M8H5GIEGR V148D occurs in many species 27 human Solubility exposed position, increased hydrophilicity, M8H5GIEGR G172Q occurs in birds

-   -   Numbering corresponds to the sequences mentioned above

TABLE 3 Predicted data for phase I variants Net ext. Co- # charge eff Hydro- amino mw (D + E) − 280 nm phob. # Variant acids (Da) pl (R + K) (cm⁻¹) index 60 human wt 197 22561 6.4 −5 1.47 −0.64 1 mouse 200 22732 6.6 −4 1.46 −0.60 2 naked mole rat 201 22741 9.2 2 1.40 −0.73 3 frog 197 22660 8.0 0 1.22 −0.79 4 chicken 197 22302 6.5 −3 1.40 −0.76 5 rabbit 201 22911 6.9 −2 1.45 −0.61 6 Sq. monkey 201 23066 7.3 −1 1.68 −0.69 7 walrus 201 22837 6.6 −4 1.39 −0.63 8 manatee 200 22469 6.6 −3 1.47 −0.54 9 plaice 202 22896 6.6 −4 0.89 −0.71 10 orangutan 201 22733 7.2 −1 1.46 −0.58 11 human P35K 201 22745 7.2 −1 1.46 −0.58 12 human M41K 201 22711 7.2 −1 1.46 −0.60 13 human R66H 201 22695 6.7 −3 1.46 −0.57 14 human T75K 201 22741 7.2 −1 1.46 −0.59 15 human T75Y 201 22776 6.9 −2 1.51 −0.58 16 human M99K 201 22711 7.2 −1 1.46 −0.60 17 human S101Y 201 22790 6.9 −2 1.51 −0.57 18 human 201 22826 6.9 −2 1.45 −0.58 K69.92.118.130R 19 coelacanth 198 22741 6.7 −3 1.38 −0.78 21 human L89T 201 22702 6.9 −2 1.46 −0.59 22 human N17.96D 201 22716 6.5 −4 1.46 −0.57 23 human T45K 201 22741 7.2 −1 1.46 −0.59 24 human A135E 201 22772 6.7 −3 1.45 −0.60 25 human V170S 201 22702 6.9 −2 1.46 −0.60 26 human V148D 201 22730 6.7 −3 1.46 −0.61 27 human G172Q 201 22785 6.9 −2 1.45 −0.59

Phase I

The variants were expressed in parallel shake-flasks. There was a variation in expression levels and for a few A1M-variants expression had to be repeated several times to obtain reasonable protein amounts. Good expression and relatively large amounts after purification (>10 mg/L culture) were obtained for mouse, squirrel monkey, walrus, orangutan, M41K, R66H, T75Y, M99K, N17,96D, T45K and V148D. The expression and amount of purified protein was similar to previous yields for human wt A1M (12 mg/L) expressed and purified under similar conditions. Variants with lower expression levels resulting in lower yields (1-10 mg/L) were naked mole rat, frog, rabbit, manatee, P35K, T75K, S101Y, L89T, V170S and G172Q. Chicken, plaice and coelacanth A1M displayed suboptimal expression levels resulting in a purification yield of <1 mg/L culture. The quadruple human mutant K69,92,118,130R expressed well, but was impossible to refold successfully. Also T75K-A1M showed increased precipitation tendencies during purification.

All variants were purified to >99% purity according to SDS-PAGE except chicken and coelacanth A1M, which were purified to 95% purity. According to SDS-PAGE all variants contained a maximum of 0.5% covalent dimers with no major differences between the variants. Circular dichroism revealed about 2% alpha helix and 40% β-sheet structure for all variants without major differences, the expected values for A1M (Kwasek et al., 2007). After purification, all variants were analysed as summarized in Table 4. Firstly, stability and solubility was analysed. The aggregation tendency and thermostability of freshly thawed, unstressed 0.1 mM protein solutions were analysed by dynamic light scattering (DLS), PAGE (aggregation) and differential scanning fluorimetry (DSF) (thermostability). In addition, the tendency to aggregate in response to shearing forces or concentration to 1 mM was investigated. Human wt A1M performed relatively well in these assays (Table 4), but some variants performed even better in the stability/solubility properties: chicken A1M, manatee A1M and N17,96D-A1M. The chicken and manatee A1M differed from human wt A1M in too many positions to enable assumptions on individual amino acids beneficial for human A1M and was not used in further studies. When functional properties were investigated, M41K and R66H were found to have the same (R66H) or improved (M41K) functions. As these variants also had higher thermostability and only slightly higher tendency to aggregate than most other variants, they were selected for further investigation. Hence, N17,96D-A1M, M41K-A1M and R66H-A1M were continued to phase II of the project.

Phase II

The aim of phase II of the project was to combine the beneficial mutations (M41K, R66H and N17,96D) to investigate if even more stable variants with similar or improved function could be constructed. In addition, the same N-terminal tag (M8H4DK) which is used for human wt A1M was introduced (Table 5). Thus, the new combined M8H4DK-variants were compared to M8H4DK-human wt.

TABLE 5 Variants expressed in phase II with predicted data Net ext. # charge coeff hydro- amino mw (D + E) − 280 nm phob. # Variant acids (Da) pl (R + K) (cm⁻¹) index 12 M8H5GIEGR- 201 22711 7.2 −1 1.46 −0.60 M41K 13 M8H5GIEGR- 201 22695 6.7 −3 1.46 −0.57 R66H 22 M8H5GIEGR- 201 22716 6.5 −4 1.46 −0.57 N17, 96D 60 M8H4DK-wt 197 22561 6.4 −5 1.47 −0.64 33 M8H4DK- 197 22539 6.4 −5 1.47 −0.67 M41K + R66H 34 M8H4DK- 197 22560 6.2 −6 1.47 −0.67 M41K + N17, 96D 35 M8H4DK- 197 22544 6.1 −8 1.47 −0.64 R66H + N17, 96D 36 M8H4DK-M41K- 197 22541 6.2 −7 1.47 −0.67 R66H + N1796D

All four new variants (M8H4DK-M41K+R66H, M8H4DK-M41K+N17,96D, M8H4DK-R66H+N17,96D and M8H4DK-M41K+R66H+N17,96D) expressed very well and yields of 29, 13, 37 and 15 mg pure protein/L were achieved. The four new variants were purified to >99% purity according to SDS-PAGE and showed the same or lower percentage of covalent dimers except M8H4DK-M41K+R66H that showed approximately 2% covalent dimers.

Solubilization/stability properties were analysed (Table 6a). Data revealed that the combination of M41K and R66H was suboptimal for thermostability. The N17,96D mutation, on the other hand, was generally beneficial for solubilization and stability, and the combination with R66H (i.e. the M8H4DK-R66H+N17,96D-A1M) yielded even better solubilization and stability.

Functional properties were analysed (Table 6b). Data showed that the M41K mutation had increased heme reduction capacity, but decreased heme binding. When the M41K mutation was combined with N17,96D, however, it showed less potential to rescue cells from heme-induced cell death. The R66H+N17,96D combination yielded similar results compared to wt-A1M in all functional aspects investigated. Therefore, the M8H4DK-tagged R66H+N17,96D A1M is a promising candidate after phase II, while the M41K-mutation is less useful.

Phase III

The first aim of phase III was to compare M8H4DK-tagged R66H+N17,96D-A1M with wt-A1M and promising M8H4DK-tagged single mutations of phase I and II, when expressed in parallel under identical conditions. The second aim was to investigate the influence of the tag on stability, solubility and function. The N-terminal tag of human wt A1M (M8H4DK) consist of 8 histidines tag (SEQ ID NO: 103) followed by an enterokinase cleavage site. The cleavage site enables cleavage of the histidine tag after expression and purification. Therefore, wt-A1M and R66H+N17,96D-A1M were expressed with N-terminal M8H4DK- and M8H-tags and without a tag. The third aim was to compare in more detail the properties of M8H4DK-wt A1M (Wt-A1M) and M8H4DK-R66H+N17,96D-A1M (35-A1M). All expressed variants of phase III with predictive data are shown in Table 7.

TABLE 7 Variants expressed in phase III with predicted data Net ext. # charge coeff hydro- amino mw (D + E) − 280 nm phob. # Variant acids (Da) pl (R + K) (cm⁻¹) index 60 M8H4DK-wt 197 22561 6.4 −5 1.47 −0.64 35 M8H4DK- 197 22544 6.1 −8 1.47 −0.64 R66H + N1796D 37 M8H4DK-M41K 197 22558 6.5 −4 1.47 −0.67 38 M8H4DK-R66H 197 22542 6.3 −8 1.47 −0.64 39 M8H4DK- 197 22563 6.1 −7 1.47 −0.64 N17.96D 40 M8H-wt 192 21973 6.9 −2 1.51 −0.57 41 M8H-R66H + 192 21956 6.4 −5 1.51 −0.56 N1796D 42 M-R66H + 184 20859 5.6 −5 1.59 −0.45 N1796D 61 M-wt 184 20876 6.3 −2 1.59 −0.45

The parallel expression and purification allowed more accurate comparison of expression levels and purification yields. It was found that all A1M variants expressing bacteria grow with the same rate (not shown) and the same relatively good yield (FIG. 2). The only difference was a slower expression of the untagged variants (#60 and #42) compared to the others. From the 2×750 ml expressions it was possible to purify 20-60 mg of each variant (FIG. 3a ). All histidine-tagged variants were purified to >99% purity, while the untagged variants (#61 and #42) showed a somewhat lower purity (around 90%) (FIG. 3b ). All displayed a low amounts of covalent dimers. PAGE analysis showed less than 1-2% large aggregates of all variants except M8H-wt (40) and untagged wt-A1M (#61) (FIG. 3c ). Thus, all single and multiple M8H4DK-tagged, M8H-tagged and untagged A1M variants could be produced.

The aggregation and thermostability of 100 μM solutions were analysed by reversed-phase HPLC, dynamic light scattering and differential scanning fluorimetry (Table 8). The M8H4DK-tagged variants were eluted in RP-HPLC at approximately 12 min, with 87-90% of the protein in the main peak. The only exception was M8H4DK-M41K that appeared at a retentation time of 9.8 minutes and only 80% of the protein in the main peak. The data once more indicate that the M41K mutation yields unexpected protein properties of A1M, and is suboptimal. Changing the tag to M8H or completely removing the tag, resulted in increased retentation times to 12.2 and 12.9 min, respectively, indicating more hydrophobic molecules, as expected. Less protein appeared in the main peak for M8H-wt and both untagged variants, possibly reflecting the slightly lower purity seen in SDS-PAGE of these variants. DLS-data indicated an average radius around 3 of all variants, and the possibility to collect data from all 6 recordings. All variants had the same or higher thermostability as M8H4DK-wt A1M. Higher stability was seen for all variants carrying the N17,96D mutation.

TABLE 8 Aggregation and thermostability of non-stressed phase III variants. DLS RP-HPLC Measure- Main Average ments RT peak (% radius used (# of DSF # variant [min] of total) (nm) 6) Tm 60 M8H4DK-wt 12.1 87 2.9 6 46.6 35 M8H4DK- 12.1 89 3.2 6 49.8 R66H + N1796D 37 M8H4DK-M41K 9.8 80 3.3 6 46.8 38 M8H4DK-R66H 12.1 89 2.9 6 46.4 39 M8H4DK- 12.1 90 3.0 6 49.7 N1796D 40 M8H-wt 12.2 78 3.2 6 47.1 41 M8H- 12.2 88 3.2 6 50.2 R66H + N1796D 61 M-wt 12.9 81 3.8 6 46.3 42 M-R66H + 12.9 82 3.4 6 50.2 N1796D

The variants of phase III were exposed to shearing forces by pipetting 80 times in a narrow pipett tip. The shearing-stress induced aggregation was the analysed with DLS. In general, all variants with the N17,96D mutation showed high tolerance towards shearing stress (Table 9), with the exception of M8H-tagged R66H+N1796D variant (#41). Also, the tolerance towards stress induced by concentration to 1 mM in different buffers was investigated. All variants were concentrated to 1 mM in 20 mM Tris-HCl+0.125M NaCl pH 8.0 or 7.4, and were immediately analysed by PAGE (FIG. 4a , Table 10). The 0.1 mM and 1 mM samples were also analysed with PAGE after a single freeze-thaw cycle in the Tris-buffers or PBS (FIG. 4b , Table 10). Among the M8H4DK-tagged variants all the N17,96D-carrying mutations displayed an increased tolerance to concentration, freeze-thawing, decreased pH and buffer-change (to PBS) compared to wt A1M. The addition of the R66H mutation improved the stability and solubility even further. The R66H mutation alone had approximately the same tolerance as wt A1M, while the M41K mutation had significantly lower tolerance. Shortening or removal of the N-terminal tag had a negative effect on the tolerance, which was more pronounced for wt A1M compared to corresponding R66H+N17,96D variants.

TABLE 9 Shearing stability of phase III variants. Average Measurements # variant radius (nm) used (#of 6) 60 M8H4DK-wt 2.9 3 35 M8H4DK-R66H + N1796D 3.0 6 37 M8H4DK-M41K 0 38 M8H4DK-R66H 0 39 M8H4DK-N1796D 3.1 6 40 M8H-wt 3.1 1 41 M8H-R66H + N1796D 0 61 M-wt 3.9 5 42 M-R66H + N1796D 3.4 6

TABLE 10 Concentration and freeze-thaw stability of phase III variants in different buffers. Large aggregates (%) 1 mM pH 8.0, 0.1 mM 1 mM pH 7.4, 1 mM PBS 0.1 mM 1 mM 1x freeze- pH 1 mM 1x freeze- pH 7.4, 1x # variant pH 8.0 pH 8.0 thaw 7.4 pH 7.4 thaw freeze-thaw 60 M8H4DK-wt 0.3 1.1 2.0 0.4 1.2 3.1 13.2 35 M8H4DK- 0.2 0.3 0.1 0.4 0.2 0.3 1.3 R66H + N1796D 37 M8H4DK-M41K 1.3 4.1 4.8 0.8 7.9 11.9 15.6 38 M8H4DK-R66H 0.6 0.5 1.0 0.2 0.7 2.4 16.0 39 M8H4DK-N1796D 0.7 1.1 0.1 0.2 0.1 0.7 2.5 40 M8H-wt 0.8 7.2 3.6 8.4 10.2 11.4 14.0 41 M8H-R66H + 0.3 0.4 0.4 0.3 0.4 1.2 7.6 N1796D 61 M-wt 0.4 2.0 2.3 9.1 1.6 3.9 17.9 42 M-R66H + N1796D 0.4 0.3 0.5 0.4 0.5 0.5 1.6

The functional activities of all phase III variants were investigated in an extended program to cover all possible aspects of known A1M functions. Non-heme related reduction capacity was investigated on the synthetic ABTS radical and in the commercially available oxygen radical antioxidant capacity (ORAC) assay (FIG. 5). M8H4DK-tagged N17,96D-A1M and R66H+N17,96D-A1M showed a similar reduction capacity as wt A1M, while M8H4DK-tagged M41K-A1M and R66H-A1M showed a slightly lower ABTS reduction capacity (FIG. 5A). Shortening or removal of the tag had little effect, but the R66H-N17,96D variants show a tendency to higher reduction capacity than wt A1M when M8H-tagged and untagged. The performance of M8H4DK-tagged wt A1M in the ORAC assay was set to 100% and the other variants were compared in relation to this. All M8H4DK-variants showed the same results in ORAC as M8H4DK-wt except M8H4DK-R66H+N17,96D which had significantly higher capacity (FIG. 5b ). Also the M8H-tagged and untagged R66H+N17,96D-A1M showed a slightly higher ORAC capacity than wt-A1M. The reduction capacity was also investigated in a cytochrome c reduction assay (FIG. 6). Most variants showed a slightly lower reduction capacity at the lower concentrations, compared to wt-A1M, and for N17,96D and R66H+N17,96D this was significant (at 0.3-0.6 μM) (FIG. 6A). The importance of this is not understood. Shortening and removal of the tag had no influence of this property.

Heme-binding was investigated in a free heme incorporation assay and in a heme-agarose binding assay (FIG. 6). The incorporation and coordination of free heme is seen as the appearance of an absorbance peak around 410-415 nm, the so-called Soret band (Karnaukhova et al., 2014; Rutardottir et al, 2016). Heme normally has an absorbance peak around 380-390 nm and this can be seen when it is dissolved alone or mixed and incubated with a non-binding control protein like ovalbumin. However, when heme is mixed with wt A1M, an absorbance peak is formed between 410-415 nm, yielding a so-called red-shift (i.e. a shift of the peak towards higher wave-lengths), and an increased Abs(413/386) ratio. It was shown that the degree of red-shift and the Abs(413/386) ratio are related to the heme-binding function of A1M (Rutardottir et al, 2016). These properties were therefore compared for all variants in phase III (FIG. 6b ). Among the M8H4DK-tagged variants all showed about the same red-shift as wt A1M except the M41K variants which had a stronger shift. Interestingly, shortening the tag to M8H increased the red-shift, while removal of the tag decreased the red-shift. Clearly, the tag had a strong influence of this property. The binding of heme to A1M was investigated as binding of a dilution series of A1M to heme-agarose in comparison to binding to a control agarose. Typically, a control protein like ovalbumin shows no binding to heme-agarose above the background binding to the control agarose (FIG. 6C). Typically, 70-80% of added M8H4DK-wt A1M (35-A1M) was bound to the heme agarose, whereas no-binding was seen to control agarose. The binding was compared for all variants in phase Ill. All showed similar degree of binding to the heme-agarose (66-72%), while ovalbumin showed no binding.

Heme binding of M8H4DK-wt A1M (wt-A1M) and M8H4DK-35-A1M (35-A1M) was further analysed (FIG. 11) using a combination of migration shift and fluorescence analysis (Karnaukhova et al. 2014). As a result of heme-incorporation, the migration of wt-A1M and 35-A1M in native PAGE analysis was slower at heme:protein ratio <1, and faster at heme:protein ratio >1, showing the same dependence upon heme-concentration (FIGS. 11A and B). At high heme concentrations, both variants showed a tendency towards oligomerization, supporting previous findings for wt-A1M (Karanaukhova et al. 2014). Likewise, heme-incorporation induced quenching of tryptophan fluorescence in both wt-A1M and 35-A1M, with similar kinetics (FIG. 11B). The coordination of heme in A1M was previously shown to induce formation of a UV-absorbance peak at 415 nm (Ruttarsdottir et al., 2016; karnaukhova et al., 2014). Similar UV-absorbance patterns of wt-A1M- and 35-A1M/heme complexes were seen (FIG. 11C), with only a small red-shift of the 35-A1M peak (415-417 nm).

The rate of reduction of ABTS-radicals of wt-A1M and 35-A1M was investigated [10] and was similar for wt-A1M and 35-A1M using unstressed, freshly prepared proteins (FIG. 12A). After storage for 7 days, wt-A1M displayed a slower reduction rate after concentration to 1 mM and at 22° C. (FIG. 12B), suggesting a loss of protein activity in addition to the aggregation shown at these conditions (Table 11). The cytochrome c-reduction (Allhorn et al., 2005) was slightly slower for 35-A1M (FIG. 12C), whereas the antioxidation capacity measured by the ORAC assay was somewhat higher for 35-A1M (FIG. 12D).

TABLE 11 Physicochemical properties of M8H4DK-wt A1M (wt-A1M) and M8H4DK-35-A1M (35-A1M). Conditions¹ Concentration Method Parameter wt-A1M 35-A1M Unstressed² 0.1 mM HPLC Elution time (min) 12.1 12.1 Monomer (%) 87 89 DLS Radius (nm) 2.9 3.2 PAGE Aggregates (%) 1.5 0.4 SEC Monomer (%) 87 93 Stressed Heat 0.1 mM DSF T_(m) (° C.) 46.6 51.6 High conc   1 mM PAGE Aggregates (%) 1.1 0.4 pH 7.4³   1 mM PAGE Aggregates (%) 1.2 0.4 Freeze-thaw²   1 mM PAGE Aggregates (%) 2.0 0.4 Freeze-thaw/PBS   1 mM PAGE Aggregates (%) 13.2 7.6 Prolonged storage⁴    4° C.-1 day   1 mM SEC Recovery⁵ (%) 100 100    Aggregates (%) 17.9 3.9 4° C.-7 days   1 mM SEC Recovery (%) 100 100    Aggregates (%) 12.1 3.7 RT-7 days   1 mM SEC Recovery (%) 44 100    Aggregates (%) 0.2 0.1 37° C.-1.5 h   1 mM SEC Recovery (%) 67 100    Aggregates (%) 53 28 37° C.-4.5 h   1 mM SEC Recovery (%) 0 44 Aggregates (%) ND⁶ 15 Footnotes: ¹Room temperature unless otherwise stated. ²20 mM Tris-HCl, 0.125M NaCl, pH 8.0 ³20 mM Tris-HCl, 0.125M NaCl, pH 7.4 ⁴PBS ⁵Calculated after centrifugation 10,000 × g, from total peak area compared to starting material. ⁶Not determined

A biologic assay where the ability of the A1M variants to rescue K562 cells from heme-induced cell death was investigated (FIG. 7). The degree of cell death, according to lactate dehydrogenase release, was set to 100% for cells incubated with heme without A1M. All M8H4DK-tagged variants, including wt-A1M, showed almost 100% rescue at 10 μM (FIG. 7), with no significant differences between the variants. The M8H-tagged variants showed almost the same rescuing potential, while a slightly lower potential was observed for the untagged variants.

Cell protection capacity of M8H4DK-wt A1M (35-A1M) and M8H4DK-35-A1M (wt-A1M) The cell protection properties of the two A1M-variants were tested in K562 cells and a human kidney proximal tubule epithelial cell line (HK-2), exposed to free heme and free iron. FIG. 12 shows that both A1M-variants completely inhibited the cell-death, measured by extracellular release of the cytosolic marker LDH, of K562-cells exposed to 0.1 mM heme. The dose-response curves of wt-A1M and 35-A1M overlaps almost completely, suggesting similar cell-protection capacities.

Protection of HK-2 cells are shown in FIG. 14. First, cell damage was induced by the Fenton reaction, a mixture of free iron, ascorbate and hydrogen peroxide which generates hydroxyl radicals. Cell viability, measured by the WST-1 assay, was restored by both A1M-variants, following overlapping dose-response curves (FIG. 14A). The upregulation of heme oxygenase-1 (HO-1), a well-documented biomarker of oxidative stress-response (Alam et al., 1999), was significantly suppressed by wt-A1M and 35-A1M to similar degrees (FIG. 14B). Cell damage of HK-2 cells was also induced by incubation with heme, and could be inhibited by both A1M-variants (FIGS. 14C and D). Again, cell viability measured by the WST-1 assay was restored by both proteins to a similar degree, using two heme concentrations, 10 and 30 μM (FIG. 14C). The upregulation of HO-1 and another cellular stress response gene, Hsp70, was inhibited to a similar degree by both A1M-variants (FIG. 14D).

In Vivo Distribution of M8H4DK-Wt A1M (Wt-A1M) and M8H4DK-35-1M (35-A1M) in Mice

Intravenously injected A1M was previously shown to be rapidly cleared from blood and predominantly localized to kidneys and liver in rats and mice (Larsson et al., 2001; Ahlstedt et al., 2015). We compared the clearance rates in blood and distribution in organs of wt-A1M and 35-A1M (FIG. 15). Similar turnover rates were seen during the first 60 min, whereas 35-A1M was cleared more rapidly after 1 h. The distribution of A1M in the investigated organs after 10 and 30 min did not show any significant differences between the two proteins. Both wt-A1M and 35-A1M were found predominantly in kidneys, and smaller amounts were seen in heart, liver, lung, skin and spleen, while neglible amounts were found in brain.

In Vivo Protection of Kidneys by M8H4DK-Wt A1M (Wt-A1M) and M8H4DK-35-A1M (35-A1M)

Previously, A1M has shown in vivo therapeutic effects in animal models where heme- and oxidative stress-related kidney injuries are induced (Wester-Rosenlöf et al., 2014; Nääv et al., 2015; Sverrison et al., 2014). Here, we investigated the in vivo protective effects of the two A1M-variants in a glycerol-injection rhabdomyolysis mouse model where acute kidney injuries (AKI) develops as a result of muscle rupture with release of myoglobin, free heme, radicals and other tissue components. The glycerol-injection resulted in a massive upregulation of the HO-1 and Hsp70 genes, two biomarkers of cellular stress (FIGS. 16A and B), and most of the upregulation was inhibited by simultaneous injection of wt-A1M or 35-A1M. No significant difference between the two A1M-variants were seen at the applied doses (7 mg/kg animal weight).

In summary, the investigations in phase III showed that the N17,96D-containing A1M-mutations significantly added stability to the A1M molecule, which was further improved when the R66H mutation was added. Furthermore, M8H4DK-tagged A1M variants were more stable than variants with a shorter tag or no tag. Therefore, the tag does not only serve as a purification tool but also provide A1M with increased stability and stability and does not interfere with function. The M8H4DK-R66H+N1796D (35-A1M) molecule show the same or better functional properties, possibly with the exception of the cytochrome c reduction. In conclusion, stability/solubility and functional studies suggest that M8H4DK-R66H+N17,96D (35-A1M) has improved molecular properties compared to M8H4DK-wt A1M (wt-A1M), and both Wt-A1M and 35-A1M show in vivo protective effects on kidneys using a rhabdomyolysis glycerol-injection model of acute kidney injury.

Further Stability Studies on M8H4DK-R66H+N1796D Vs M8H4DK-Wt.

To further compare M8H4DK-R66H+N17,96D-A1M and wt-A1M, aggregation and function were tested with SEC-FPLC and the ABTS reduction assay after freeze-thaw cycles and storage at +4° C. and room temperature (FIG. 8). Samples (100 μM) of wt-A1M and R66H+N17,96D-A1M both tolerated 5× freeze-thaw cycles very well. As previously shown wt-A1M showed more aggregation after concentration to 1 mM than R66H+N17,96D-A1M, and similar results were seen after storage for 1 week compared to overnight. The increased aggregation of wt-A1M did not affect the ABTS reduction activity of 2 μM-samples. Ocular inspections show completely clear solutions of both variants after freeze-thaw, concentration and storage for 1 week at +4° C. To stress the A1M solutions further, 100 μM and 1 mM solutions were stored in room temperature for 1 week. Ocular inspection of the 100 μM solutions showed a slight cloudiness of wt-A1M, but the R66H+N17,96D-A1M solution remained clear. SEC-FPLC showed a decreased area under the curve of wt-A1M to 80% of the starting material, indicating loss of wt-A1M, although no increase in large aggregates was seen. The loss was most likely caused by precipitation of protein and removal by the filtration before the FPLC-run. For R66H+N17,96D-A1M, some increased aggregation could be seen, but no loss of protein after the storage at room-temperature for one week at 100 μM. In the ABTS assay, R66H+N17,96D-A1M still showed full activity, while a small decrease was seen for wt-A1M. Ocular inspection of 1 mM solutions stored for 1 week showed cloudiness of both variants, but the wt-A1M solution appeared thicker. When the solutions were diluted 10 times for loading onto the SEC, the precipitate of the R66H+N17,96D-A1M, but not wt-A1M, was resolved. In the SEC, very little aggregates were seen, but only 44% of the wt-A1M starting material remained. In contrast, 100% of R66H+N17,96D-A1M remained. In the ABTS assay wt-A1M had seriously decreased activity while the activity of R66H+N17,96D-A1M stayed the same. This study shows that M8H4DK-R66H+N17,96D-A1M can tolerate storage at high concentrations at room temperature, whereas wt-A1M cannot.

The stability of 1 mM solutions at 37° C. was investigated. The samples were incubated for 1.5, 2.5 and 4.5 h and then ocularly inspected, analysed by SEC-FPLC and the ABTS reduction assay (FIG. 9). After 1.5 h incubation, both solutions were still clear when ocularly inspected, but the SEC-FPLC revealed more aggregates in the wt-A1M solution (53%) compared to the R66H+N17,96D-A1M solution (28%). Only 67% of the starting material was eluted on the SEC of wt-A1M, while 100% was eluted of R66H+N17,96D-A1M, estimated by the area under the curve. Both variants showed full activity in the ABTS assay. After 2.5 h of incubation the wt-A1M solution had become cloudy with precipitates impossible to resolve. 40% of the starting material was found on the SEC and the ABTS activity was significantly decreased. The R66H+N17,96D-A1M solution was still clear and showed full activity in the ABTS assay, but large aggregates had increased from 28 to 38% in the SEC-FPLC. After 4.5 h, the wt-A1M had developed into a thick substance, impossible to pipett. Therefore, it was not further analysed. The R66H+N17,96D-A1M had become cloudy, but was still possible to pipette. Some precipitation remained after dilution. The amount of protein eluted on the SEC was 44% of the starting material and a decreased activity in the ABTS assay was seen. The study suggest that following incubation at +37° C., A1M first forms resolvable aggregates, then it forms irreversible aggregates and loss of activity in the ABTS assay. Complete irreversible precipitation of wt-A1M was seen after 2.5 hours of incubation, and partial irreversible precipitation was seen only after 4.5 hours for M8H4DK-R66H+N17,96D-A1M. Hence, M8H4DK-R66H+N17,96D-A1M is more resistant to storage at +37° C. than M8H4DK-wt-A1M.

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1-24. (canceled)
 25. An alpha-1-microglobulin protein variant having an amino acid sequence selected from: the amino acid sequence consisting of formula I (SEQ ID NO:10): X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²-X¹³-X⁴-GPVPTPPDNIQVQENF-X¹⁵-ISRIYGKWYNLAIGSTCPWLKKI-X¹⁶-DRMTVSTLVLGEGATEAEISMTST-X¹⁷-WRKGVCEETSGAYEKTDTDGKFLYHKSKW-X¹⁸-ITMESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAPQLRETLLQDFRVVAQGVGIPEDSIFTMADRGECVPGEQEPEPILIPR (formula I), and the amino acid sequence consisting of formula II (SEQ ID NO: 17): (SEQ ID NO: 17) X¹-X²-X³-X⁴-X⁵-X⁶-X⁷-X⁸-X⁹-X¹⁰-X¹¹-X¹²-X¹³-X¹⁴-GPVPTPPDN IQVQENF-X¹⁵-ISRIYGKWYNLAIGSTCPWLKKI-X¹⁶-DRMTVSTLVLG EGATEAEISMTST-X¹⁷-WRKGVCEETSGAYEKTDTDGKFLYHKSKW-X¹⁸- ITMESYVVHTNYDEYAIFLTKKFSRHHGPTITAKLYGRAPQLRETLLQDF RVVAQGVGIPEDSIFTMADRGECVPGEQEPEPI,

wherein at least one of X¹-X¹⁴ is present; X¹ is absent or represents Met or N-formyl Met; X² is absent or represents His; X³ is absent or represents His; X⁴ is absent or represents His; X⁵ is absent or represents His; X⁶ is absent or represents His; X⁷ is absent or represents His; X⁸ is absent or represents His; X⁹ is absent or represents His; X¹⁰ is absent or selected from Asp, Glu, Lys, or Arg; X¹¹ is absent or selected from Asp, Glu, Lys, or Arg; X¹² is absent or selected from Asp, Glu, Lys, or Arg; X¹³ is absent or selected from Asp, Glu, Lys, or Arg; X¹⁴ is absent or selected from Asp, Glu, Lys, or Arg; X¹⁵ represents Asp or Asn; X¹⁶ represents Met or Lys or Arg; X¹⁷ represents Arg or His or Lys; X¹⁸ represents Asp or Asn; or a pharmaceutically acceptable salt thereof, with the proviso that the amino acid sequence is not SEQ ID NO: 1 or SEQ ID NO:
 2. 26. An alpha-1-microglobulin protein variant according to claim 25, wherein X¹ is Met or N-formyl Met, X²-X⁷ are His, X⁸ and X⁹ are absent, X¹⁰-X¹³ are Asp, X¹⁴ is Lys, and X¹⁵-X¹⁸ are present.
 27. An alpha-1-microglobulin protein variant according to claim 25, wherein X¹ is Met or N-formyl Met, X²-X⁹ are His, X¹⁰-X¹³ are Asp, X¹⁴ is Lys, and X¹⁵-X¹⁸ are present.
 28. An alpha-1-microglobulin protein variant according to claim 25, wherein X¹ is Met, X²-X¹⁴ are absent, X¹⁵ is Asp, X¹⁶ is Met, X¹⁷ is His, and X¹⁸ is Asp.
 29. An alpha-1-microglobulin protein variant according to claim 28, having the amino acid sequence of SEQ ID NO:3 or SEQ ID NO:18.
 30. An alpha-1-microglobulin protein variant according to claim 25, wherein X¹ is Met, X²-X¹⁴ are absent, X¹⁵ is Asn, X¹⁶ is Lys, X¹⁷ is Arg, and X¹⁸ is Asn.
 31. An alpha-1-microglobulin protein variant according to claim 30, having the amino acid sequence of SEQ ID NO:4 or SEQ ID NO:19.
 32. An alpha-1-microglobulin protein variant according to claim 25, wherein X¹ is Met or N-formyl Met, X²-X⁷ are His, X⁸ and X⁹ are absent, X¹⁰-X¹³ are Asp, X¹⁴ is Lys, X¹⁵ is Asp, X¹⁶ is Met, X¹⁷ is His, and X¹⁸ is Asp.
 33. An alpha-1-microglobulin protein variant according to claim 32, having the amino acid sequence of SEQ ID NO: 5 or SEQ ID NO:
 20. 34. An alpha-1-microglobulin protein variant according to claim 25, wherein X¹ is Met or N-formyl Met, X²-X⁷ are His, X⁸ and X⁹ are absent, X¹⁰-X¹³ are Asp, X¹⁴ is Lys, X¹⁵ is Asn, X¹⁶ is Lys, X¹⁷ is Arg, and X¹⁸ is Asn.
 35. An alpha-1-microglobulin protein variant according to claim 10, having the amino acid sequence of SEQ ID NO:6 or SEQ ID NO:21.
 36. An alpha-1-microglobulin protein variant according to claim 25, wherein X¹ is Met or N-formyl Met, X²-X⁹ are His, X¹⁰-X¹³ are Asp, X¹⁴ is Lys, X¹⁵ is Asp, X¹⁶ is Met, X¹⁷ is His, and X¹⁸ is Asp.
 37. An alpha-1-microglobulin protein variant according to claim 36, having the amino acid sequence of SEQ ID NO:7 or SEQ ID NO:22.
 38. An alpha-1-microglobulin protein variant according to claim 25, wherein X¹ is Met or N-formyl Met, X²-X⁹ are His, X¹⁰-X¹³ are Asp, X¹⁴ is Lys, X¹⁵ is Asn, X¹⁶ is Lys, X¹⁷ is Arg, and X¹⁸ is Asn.
 39. An alpha-1-microglobulin protein variant according to claim 38, having the amino acid sequence of SEQ ID NO:8 or SEQ ID NO:23.
 40. An alpha-1-microglobulin protein variant according to claim 25, wherein the protein variant is an antioxidant.
 41. An alpha-1-microglobulin protein variant according to claim 25, wherein the protein variant binds heme.
 42. A pharmaceutical composition comprising an alpha-1-microglobulin protein variant according to claim 25 and one or more pharmaceutically acceptable excipients.
 43. A method of treatment, comprising administering an alpha-1-microglobulin protein variant according to claim 25 to a subject in need thereof. 